Provider Demographics
NPI:1427143759
Name:PILLAI, BALA M (PT)
Entity type:Individual
Prefix:MRS
First Name:BALA
Middle Name:M
Last Name:PILLAI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CHAMBLEE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-4686
Mailing Address - Country:US
Mailing Address - Phone:908-227-2139
Mailing Address - Fax:
Practice Address - Street 1:1020 CHAMBLEE CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4686
Practice Address - Country:US
Practice Address - Phone:908-227-2139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00514400225100000X
NCP22006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097885Medicare ID - Type Unspecified