Provider Demographics
NPI:1508214412
Name:BALEN, ALEJANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRA
Middle Name:
Last Name:BALEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7003
Mailing Address - Country:US
Mailing Address - Phone:978-741-4133
Mailing Address - Fax:978-741-7742
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-7003
Practice Address - Country:US
Practice Address - Phone:978-741-4133
Practice Address - Fax:978-741-7742
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA291157208800000X
RILP03718208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery