Provider Demographics
NPI:1770576399
Name:BALER, JOSEPH SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:BALER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4 PALISADES DR
Mailing Address - Street 2:STE 240
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1443
Mailing Address - Country:US
Mailing Address - Phone:578-446-0172
Mailing Address - Fax:518-446-0182
Practice Address - Street 1:4 PALISADES DR
Practice Address - Street 2:STE 240
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1443
Practice Address - Country:US
Practice Address - Phone:578-446-0172
Practice Address - Fax:518-446-0182
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY171899207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01417436Medicaid
NY07114OtherMVP HEALTHCARE
NY10000086OtherCAP DIST PHYS HEALTH PLAN
F46444Medicare UPIN
NY07114OtherMVP HEALTHCARE