Balashov, Konstantin
Balashov, Konstantin is an individual health care provider with primary practice located at 725 Albany Street, Suite 7B Shapiro Bldg, Boston MA 02118. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Balashov, Konstantin can be contacted via phone (617) 638-8456.Contact Information
Primary practice address
725 Albany Street, Suite 7B Shapiro Bldg
Boston MA 02118
Phone: (617) 638-8456
Fax: (617) 638-8465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 220320 | Massachusetts |
Profile Details
| NPI number | 1083789556 |
|---|---|
| LBN Legal business name | Balashov, Konstantin |
| Credentials | MD, PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 21st, 2006 |
| Last updated | May 24th, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083789556 | NPPES |
| New Hampshire | MEDICAID | 3125305 | |
| New Hampshire | MEDICAID | 110164678A | |
| New Hampshire | MEDICAID | 0065951 |
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