Provider Demographics
NPI:1740251552
Name:BALTI, MUBEENA AKHTER (MD)
Entity type:Individual
Prefix:MRS
First Name:MUBEENA
Middle Name:AKHTER
Last Name:BALTI
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 1:350 ALBERTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-836-8380
Mailing Address - Fax:716-836-1873
Practice Address - Street 1:350 ALBERTA DRIVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-836-8380
Practice Address - Fax:716-836-1873
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152275207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00751359Medicaid
NY00010009701OtherUNIVERA
NY0700729OtherINDEPENDENT HEALTH
NY000508754001OtherBLUE CROSS
NY00010009701OtherUNIVERA
NY0700729OtherINDEPENDENT HEALTH