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General NPI Number Information
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NPI Number | 1891643938
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Entity Type | Organization
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Legal Business Name | BALANCED OT WELLNESS, PLLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 54 N COUNTRY RD
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City | MILLER PLACE
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State | NY
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Zip | 11764-1446
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Country | US
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Telephone | 516-226-0367
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Fax |
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Provider Business Mailing Address
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Address Line | 43 SHERWOOD DR
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City | SHOREHAM
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State | NY
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Zip | 11786-2053
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Country | US
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Telephone | 631-484-9687
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | TINA-MARIE MARTIRANO
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Credential | OTR/L
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Telephone | 631-484-9687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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