Provider Demographics
NPI:1194899013
Name:BALKAN, DAVID (MPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BALKAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 MORRIS AVE STE A101
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5746
Mailing Address - Country:US
Mailing Address - Phone:908-486-4400
Mailing Address - Fax:908-259-2760
Practice Address - Street 1:2333 MORRIS AVE STE A101
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5746
Practice Address - Country:US
Practice Address - Phone:908-486-4400
Practice Address - Fax:908-259-2760
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA007492002251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic