Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 1527131 | NY |
NPI | 1043386626 |
---|---|
Provider Name | Dr. Wendy Balopole |
First Address | Mineola, NY 11501-4064 |
Second Address | Mineola, NY 11501-4064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 24/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A52747 | (02) | NY |