Provider Demographics
NPI:1285292060
Name:BALAOING, VENUS SORIANO (APN)
Entity type:Individual
Prefix:
First Name:VENUS
Middle Name:SORIANO
Last Name:BALAOING
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 WAYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3618
Mailing Address - Country:US
Mailing Address - Phone:732-927-3721
Mailing Address - Fax:
Practice Address - Street 1:583 WAYSIDE RD
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3618
Practice Address - Country:US
Practice Address - Phone:732-927-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00910000363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty