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Contact Information

ENRIQUE BALLESTEROS, MD
263 FARMINGTON AVE
FARMINGTON, CT06030-3985
 Phone: 860-679-2980
 Fax: 860-679-4334
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for ENRIQUE BALLESTEROS · (Male)

NPI # 1972594497
Status Active
Credentials MD
Entity Individual
Enumeration date 11/03/2005
Last updated 11/07/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 039969
  • CT Medicaid 1972594497
Hospital affiliation(s)
  • JOHN DEMPSEY HOSPITAL - (Acute Care)
    263 FARMINGTON AVE
    FARMINGTON, CT 06032
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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