Provider Demographics
NPI:1770997793
Name:BALANCED BODY ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:BALANCED BODY ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIREH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:973-304-1506
Mailing Address - Street 1:792 POMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1229
Mailing Address - Country:US
Mailing Address - Phone:973-304-1506
Mailing Address - Fax:
Practice Address - Street 1:792 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1229
Practice Address - Country:US
Practice Address - Phone:973-304-1506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00063800261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center