Provider Demographics
NPI:1902186349
Name:BALASKONIS, ASIMINA (DPM)
Entity Type:Individual
Prefix:MS
First Name:ASIMINA
Middle Name:
Last Name:BALASKONIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 W 47TH ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-2373
Mailing Address - Country:US
Mailing Address - Phone:267-254-4733
Mailing Address - Fax:914-361-6471
Practice Address - Street 1:454 W 47TH ST APT 3E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-2373
Practice Address - Country:US
Practice Address - Phone:267-254-4733
Practice Address - Fax:914-361-6471
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006431213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery