Provider Demographics
NPI:1104189059
Name:BALANCE WELLNESS THERAPY: OCCUPATIONAL THERAPISTS, PLLC
Entity Type:Organization
Organization Name:BALANCE WELLNESS THERAPY: OCCUPATIONAL THERAPISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BEFANIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:914-588-2143
Mailing Address - Street 1:77 BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:PINE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12567-5009
Mailing Address - Country:US
Mailing Address - Phone:914-588-1446
Mailing Address - Fax:845-678-3456
Practice Address - Street 1:77 BOWMAN RD
Practice Address - Street 2:
Practice Address - City:PINE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12567-5009
Practice Address - Country:US
Practice Address - Phone:914-588-1446
Practice Address - Fax:845-678-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010823225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty