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BRENDA K. BALCH M.D.

>> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1891895595

Individual Registrant:
 BRENDA K. BALCH M.D.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
53 C GRANITE STREET  NEW LONDON, CT 06320 US
Tel: 860-442-8817  Fax: 860-442-2011

Contact information for business:
53 C GRANITE STREET  NEW LONDON, CT 06320 US
Tel: 860-442-8817  Fax: 860-442-2011

Registration Information:
NPI: 1891895595
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
CT031470

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS010031470CT0101
OXFORDNLP07101
BLUE CARE FAMILY PLAN001314707-0001
HEALTH NETOV615201




HEALTH CARE JOBS CT - Page 1



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