DR. FABIOLA SARA BALAREZO (NPI# 1134121064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134121064 |
| Entity Type | Individual |
| Full Name | DR. FABIOLA SARA BALAREZO |
| Other Name | FABIOLA BALAREZO DIAZ |
| Credential | M.D. |
| Practice Address |
2 Trap Falls Road Suite 414 Shelton CT 06484-7354 |
| Mailing Address |
99 East River Drive 5th Floor East Hartford CT 06108-7301 |
| Practice Telephone | 2039297353 |
| Practice Fax Number | 2039290756 |
| Mailing Telephone | 8602824128 |
| Mailing Fax Number | 8602820170 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2016-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
037679 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001376799 | 05 |
| Street Address |
2 TRAP FALLS ROAD SUITE 414 |
| City | SHELTON |
| State | CT |
| Zip Code | 06484-7354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528593555 | Lisa Girardin | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2017-04-27 |
| 1194257956 | Daveneet Randhawa | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2017-03-31 |
| 1689106924 | Rachel Petree | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2017-03-28 |
| 1891239315 | Melissa Soto | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484-7523 | 2016-12-19 |
| 1053853937 | David White | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484-7353 | 2016-11-09 |
| 1164973145 | Natalie Berardesca | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2016-10-14 |
| 1356892335 | Kirstie Phillips | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2016-10-14 |
| 1437600426 | Cally Regan | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2016-10-14 |
| 1720538192 | Geralou Marie Jamandre | Nurse Anesthetist, Certified Registered | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2016-10-10 |
| 1891241147 | Joshua Matlin | Student in an Organized Health Care Education/Training Program | 2 Trap Falls Road, Suite 414, Shelton, CT 06484 | 2016-08-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949517 | Judy Ports | Speech-Language Pathologist | 100 Bear Sawmill Rd, Shelton, CT 06484 | 2020-07-22 |
| 1144793340 | Theodore N. Zengou | Pharmacist | 875 Bridgeport Av., Shelton, CT 06484 | 2019-01-10 |
| 1194215046 | Brightview Shelton LLC | Alzheimer Center (Dementia Center) | 30 Beard Sawmill Road, Shelton, CT 06484 | 2018-05-16 |
| 1477071264 | Emily Buccigross | Specialist/Technologist | 941 Constitution Blvd N, Shelton, CT 06484 | 2017-09-01 |
| 1134649643 | Margaret Grace Ferrara | Dentist | 4 Corporate Dr Ste 383, Shelton, CT 06484 | 2017-06-26 |
| 1376092007 | Qmg3 LLC | Family Medicine | 405 Bridgeport Avenue, Shelton, CT 06484 | 2016-09-22 |
| 1215316427 | Marcella N. Sancho, Lcsw, LLC | Social Worker | 4 Research Drive, Suite 402, Shelton, CT 06484 | 2015-05-20 |
| 1578987483 | Lisa Sych | Speech-Language Pathologist | 584 Long Hill Avenue- Bishop Wicke Health Center, Shelton, CT 06484 | 2014-02-12 |
| 1073936324 | Jeanne M. Kellogg | Occupational Therapy Assistant | 36 Fairlane Dr., Shelton, CT 06484 | 2014-01-22 |
| 1851724454 | Brittany Steiner | Behavioral Analyst | 26 Pound Ridge Ave, Shelton, CT 06484 | 2013-08-19 |
| Find all providers in zip 06484 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659404481 | Gary Scott Tennyson | Pathology | 1 Forest Pkwy, Shelton, CT 06484-6147 | 2007-03-13 |
| 1134210099 | Linda Trapkin | Pathology | 1 Greenwich Pl, Shelton, CT 06484-7603 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730625856 | Karen Blomquist | Pathology | 43 Essex Ln, Woodbury, CT 06798-2631 | 2017-01-12 |
| 1508244070 | Pallavi Patil | Pathology | 20 York St # Ep2-612, New Haven, CT 06510-3220 | 2015-05-15 |
| 1477968261 | Chen Yang | Pathology | 310 Cedar St # Lh108, New Haven, CT 06510 | 2014-06-30 |
| 1023436029 | Physicians for Women's Health, LLC | Pathology | 22 Waterville Rd, Avon, CT 06001-2066 | 2014-04-07 |
| 1295077790 | Gordon Seth Cohen | Pathology | 3 Silo Hill Road, Madison, CT 06443 | 2013-03-22 |
| 1841557949 | Lewis Morton Portnoy | Pathology | 10 Linda Ln, Westport, CT 06880-3945 | 2012-04-13 |
| 1730475963 | Patricia Marie Raciti | Pathology | Greenwich Hospital, 5 Perryridge Road, Greenwich, CT 06830 | 2011-06-27 |
| 1538452594 | Lois Wurzel | Pathology | 77 Bayberry Hill Rd, Avon, CT 06001-2800 | 2011-05-24 |
| 1134377344 | Andrew Stuart Radow | Pathology | 16 Lawton Dr, Simsbury, CT 06070-2725 | 2008-08-29 |
| 1699937748 | Heather Mary Carney | Pathology | 2800 Main, Dept. of Pathology, Bridgeport, CT 06606-4201 | 2008-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.