Provider Demographics
NPI:1144689571
Name:HEIFETZ-BALERNA, SHERYL LYNN
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNN
Last Name:HEIFETZ-BALERNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 COLBY DR
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1002
Mailing Address - Country:US
Mailing Address - Phone:781-738-6141
Mailing Address - Fax:
Practice Address - Street 1:59 COLBY DR
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:MA
Practice Address - Zip Code:02338-1002
Practice Address - Country:US
Practice Address - Phone:781-738-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program