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Vita Merylle Balista

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as VITA BALISTA.

Based on the most recent information from CMS, provider Vita Merylle Balista is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1952079485
Provider Type
Individual
Full Name
Balista, Vita Merylle
Gender
Female

Sole Proprietor
No
Enumeration Date
8/31/2021
Last Updated
5/19/2023

Contact Information

Practice Location

100 Woods Rd, Valhalla, NY 10595-1530

(914) 493-7518

(914) 493-8130

Mailing Location

100 Woods Rd, Valhalla, NY 10595-1530

(914) 493-7518

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License F347217-01 New York

Vita Merylle Balista

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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