| Telemental Associates | |
|
3507 Lyndale Ave S Minneapolis MN 55408-4159 | |
| (612) 810-6414 | |
| (802) 210-4139 |
| Full Name | Telemental Associates |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 3507 Lyndale Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Gerard Balan (CEO/OWNER) |
| Authorized Official Contact | 6128106414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telemental Associates 3507 Lyndale Ave S Minneapolis MN 55408-4159 Ph: (612) 810-6414 | Telemental Associates 3507 Lyndale Ave S Minneapolis MN 55408-4159 Ph: (612) 810-6414 |
| NPI Number | 1265128979 |
|---|---|
| Provider Enumeration Date | 04/14/2023 |
| Last Update Date | 12/20/2023 |
| Certification Date | 12/20/2023 |
| Medicare PECOS PAC ID | 1658737747 |
|---|---|
| Medicare Enrollment ID | O20230516000411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265128979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Gerard Balan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518108455 PECOS PAC ID: 1759430937 Enrollment ID: I20111021000316 |
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