Basic Information
| Provider Information | |||||||||
| NPI: | 1831158922 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BALATBAT | ||||||||
| FirstName: | GILBERT | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 E RIVER DR | ||||||||
| Address2: | 5TH FL | ||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061083288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602824022 | ||||||||
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| Practice Location | |||||||||
| Address1: | 394 W CENTER ST | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060404735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607590060 | ||||||||
| FaxNumber: | 8606336041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 04/11/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 042064 | CT | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 042064 | CT | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.