Provider Demographics
NPI:1184948630
Name:BALOTTI, RICHARD FRANKLIN JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANKLIN
Last Name:BALOTTI
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 34990
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0627
Mailing Address - Country:US
Mailing Address - Phone:610-644-6900
Mailing Address - Fax:833-941-3871
Practice Address - Street 1:266 LANCASTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3256
Practice Address - Country:US
Practice Address - Phone:610-644-6900
Practice Address - Fax:833-941-3871
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09137700208100000X
PAMD456186208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation