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General NPI Number Information
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NPI Number | 1487811691
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Entity Type | Organization
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Legal Business Name | BALANCE CHIROPRACTIC & WELLNESS, P.C.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 198 NEW YORK AVE #1
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City | HUNTINGTON
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State | NY
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Zip | 11743-2746
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Country | US
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Telephone | 631-470-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 198 NEW YORK AVE #1
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City | HUNTINGTON
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State | NY
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Zip | 11743-2746
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. PAUL BEBERMAN
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Credential | DC
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Telephone | 631-470-9670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010971
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License Number State | NY
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