Provider Demographics
NPI:1235429960
Name:EQUILIBRIUM CENTER FOR DIZZINESS & BALANCE, LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:EQUILIBRIUM CENTER FOR DIZZINESS & BALANCE, LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDO-BRENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-490-0408
Mailing Address - Street 1:13 CORNWALL DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1107
Mailing Address - Country:US
Mailing Address - Phone:609-490-0408
Mailing Address - Fax:
Practice Address - Street 1:13 CORNWALL DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1107
Practice Address - Country:US
Practice Address - Phone:609-490-0408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty