Balanced Well Medical Network | |
23-08 Maple Ave Fair Lawn NJ 07410-1583 | |
(201) 794-4500 | |
(201) 794-4502 |
Full Name | Balanced Well Medical Network |
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Speciality | Family Medicine |
Location | 23-08 Maple Ave, Fair Lawn, New Jersey |
Authorized Official Name and Position | Roth Leon Riley (DIRECTOR) |
Authorized Official Contact | 2017944500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Balanced Well Medical Network 23-08 Maple Ave Fair Lawn NJ 07410-1583 Ph: (201) 794-4500 | Balanced Well Medical Network 23-08 Maple Ave Fair Lawn NJ 07410-1583 Ph: (201) 794-4500 |
NPI Number | 1295181584 |
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Provider Enumeration Date | 05/05/2016 |
Last Update Date | 05/05/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295181584 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 25MA09551100 (New Jersey) | Primary |
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