Provider Demographics
NPI:1316074610
Name:BALAKIRSKY, ELENA C (MD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:C
Last Name:BALAKIRSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WALKER AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4078
Mailing Address - Country:US
Mailing Address - Phone:410-580-1220
Mailing Address - Fax:410-520-1226
Practice Address - Street 1:19 WALKER AVE STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-4078
Practice Address - Country:US
Practice Address - Phone:410-580-1220
Practice Address - Fax:410-520-1226
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067640208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics