Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG000676 | PA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OEG000676 | PA |
NPI | 1003814559 |
---|---|
Provider Name | Dr. Thomas Balitski |
First Address | Monaca, PA 15061-3149 |
Second Address | Monaca, PA 15061-3149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 29/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001266939001 | (05) | PA |
1317065 | HIGHMARK GRP. # (01) | PA |
234607 | HEALTHAMERICA GRP. # (01) | PA |
255641 | HEALTHAMERICA IND. # (01) | PA |
314110 | UPMC (01) | PA |
BA701466 | HIGHMARK IND. # (01) | PA |
U26384 | (02) | PA |