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General NPI Number Information
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NPI Number | 1881807014
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Entity Type | Organization
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Legal Business Name | BALANCE INVALID COACH,INC.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1215 LIBERTY AVE SUITE# 27
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City | HILLSIDE
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State | NJ
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Zip | 07205-2054
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Country | US
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Telephone | 973-332-1127
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Fax | 973-395-2724
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Provider Business Mailing Address
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Address Line | 1215 LIBERTY AVE SUITE# 27
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City | HILLSIDE
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State | NJ
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Zip | 07205-2054
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Country | US
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Telephone | 973-332-1127
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Fax | 973-395-2724
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Authorized Official
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Title or Position | OWNER
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Name | MR. GAMAL E YAHYA
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Credential |
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Telephone | 973-332-1127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 7687206
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License Number State | NJ
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