Provider Demographics
NPI:1942201900
Name:BALBI, HOWARD JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JORGE
Last Name:BALBI
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 1:655 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1314
Mailing Address - Country:US
Mailing Address - Phone:631-321-2100
Mailing Address - Fax:631-321-2246
Practice Address - Street 1:655 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1314
Practice Address - Country:US
Practice Address - Phone:631-321-2100
Practice Address - Fax:631-321-2246
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1696232080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01349164Medicaid
NY01349164Medicaid
NYE46854Medicare UPIN