Provider Demographics
NPI:1568460491
Name:BALAR, NILESH N (MD)
Entity Type:Individual
Prefix:MR
First Name:NILESH
Middle Name:N
Last Name:BALAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5700
Mailing Address - Country:US
Mailing Address - Phone:718-823-7135
Mailing Address - Fax:718-823-7136
Practice Address - Street 1:3175 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5700
Practice Address - Country:US
Practice Address - Phone:718-823-7135
Practice Address - Fax:718-823-7136
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2096802086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01974354Medicaid
NJ087637TSHMedicare PIN
822L331Medicare ID - Type Unspecified
H00591Medicare UPIN