Basic Information
| Provider Information | |||||||||
| NPI: | 1790938819 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IN-BALANCE HEALTH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 SHIELD DR | ||||||||
| Address2: | |||||||||
| City: | WOODCLIFF LAKE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076778128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014760020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8 CHESTNUT RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | MONTVALE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076451802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013918282 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2008 | ||||||||
| LastUpdateDate: | 11/03/2008 | ||||||||
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| AuthorizedOfficialLastName: | LAMBERT | ||||||||
| AuthorizedOfficialFirstName: | RICK | ||||||||
| AuthorizedOfficialMiddleName: | OWEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2014760020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | MA050161 | NJ | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.