Provider Demographics
NPI:1427439470
Name:DROMA BALGOBIN
Entity type:Organization
Organization Name:DROMA BALGOBIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:DROMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALGOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-328-4657
Mailing Address - Street 1:2254 STORY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-1326
Mailing Address - Country:US
Mailing Address - Phone:347-328-4657
Mailing Address - Fax:
Practice Address - Street 1:2254 STORY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473
Practice Address - Country:US
Practice Address - Phone:347-328-4657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY698194282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0000000000Medicare NSC