Provider Demographics
NPI:1558140731
Name:BALANCED NUTRITION NYC, PLLC
Entity Type:Organization
Organization Name:BALANCED NUTRITION NYC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:718-704-6900
Mailing Address - Street 1:253 CUMBERLAND ST APT 305
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4622
Mailing Address - Country:US
Mailing Address - Phone:718-704-6900
Mailing Address - Fax:
Practice Address - Street 1:253 CUMBERLAND ST APT 305
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4622
Practice Address - Country:US
Practice Address - Phone:718-704-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty