Provider Demographics
NPI:1285944736
Name:BALDER, FELIX (DO)
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:
Last Name:BALDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 BOYLSTON ST
Mailing Address - Street 2:MALL AT CHESTNUT HILL
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1692
Mailing Address - Country:US
Mailing Address - Phone:617-969-5050
Mailing Address - Fax:
Practice Address - Street 1:199 BOYLSTON ST
Practice Address - Street 2:MALL AT CHESTNUT HILL
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1692
Practice Address - Country:US
Practice Address - Phone:617-969-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4015156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician