Provider Demographics
NPI:1205066743
Name:BALANCED HEALTH MEDICAL
Entity type:Organization
Organization Name:BALANCED HEALTH MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:CALABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-755-1717
Mailing Address - Street 1:133 E 58TH ST.
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-755-1515
Mailing Address - Fax:212-755-7021
Practice Address - Street 1:133 E 58TH ST.
Practice Address - Street 2:SUITE 1101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-755-1515
Practice Address - Fax:212-755-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141670174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty