Provider Demographics
NPI:1962607648
Name:BALIKO, FRANK (STUDENT)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:BALIKO
Suffix:
Gender:M
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 TRANSIT RD APT T6
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4945
Mailing Address - Country:US
Mailing Address - Phone:315-278-4096
Mailing Address - Fax:
Practice Address - Street 1:4974 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4616
Practice Address - Country:US
Practice Address - Phone:176-685-9631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program