Provider Demographics
NPI:1467151514
Name:BALANCE CHOICE CARE
Entity Type:Organization
Organization Name:BALANCE CHOICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS-SANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:212-729-9263
Mailing Address - Street 1:7 MARCUS GARVEY BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5303
Mailing Address - Country:US
Mailing Address - Phone:212-729-9263
Mailing Address - Fax:
Practice Address - Street 1:7 MARCUS GARVEY BLVD STE 410
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5303
Practice Address - Country:US
Practice Address - Phone:212-729-9263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05741635Medicaid
NY1557604717OtherMEDICARE