Provider Demographics
NPI:1861565780
Name:BALKIN, MICHAEL S (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:BALKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:191 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2987
Mailing Address - Country:US
Mailing Address - Phone:631-549-2525
Mailing Address - Fax:516-432-2831
Practice Address - Street 1:191 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2987
Practice Address - Country:US
Practice Address - Phone:631-549-2525
Practice Address - Fax:516-432-2831
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY120257207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09437Medicare UPIN
NY38A091Medicare PIN