Provider Demographics
NPI:1265599583
Name:BALTER, ANDREW LLOYD (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LLOYD
Last Name:BALTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:234 CHURCH ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-1804
Mailing Address - Country:US
Mailing Address - Phone:203-787-5938
Mailing Address - Fax:203-787-9447
Practice Address - Street 1:234 CHURCH ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1804
Practice Address - Country:US
Practice Address - Phone:203-787-5938
Practice Address - Fax:203-787-9447
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0182122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT79932OtherMHN
CT010018212CT01OtherANTHEM BLUE CROSS
CT049763OtherVALUE OPTIONS
CTNHS129OtherOXFORD HEALTH
CT79932OtherMHN