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General NPI Number Information
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NPI Number | 1063168920
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Entity Type | Organization
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Legal Business Name | BALANCE PODIATRY PLLC
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/13/2022
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Provider Practice Location Address
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Address Line | 119 N PARK AVE STE 208
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4113
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Country | US
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Telephone | 631-694-8342
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Fax |
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Provider Business Mailing Address
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Address Line | 5 MARLBOROUGH CT
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1822
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Country | US
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Telephone | 516-425-1727
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ELIZABETH PISELLI
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Credential | DPM
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Telephone | 516-425-1727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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