Provider Demographics
NPI:1811359144
Name:BALANCING HEALTH LLC
Entity type:Organization
Organization Name:BALANCING HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:SOTO-PERELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-234-8357
Mailing Address - Street 1:516 51ST ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-5553
Mailing Address - Country:US
Mailing Address - Phone:201-293-5002
Mailing Address - Fax:
Practice Address - Street 1:516 51ST ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-5553
Practice Address - Country:US
Practice Address - Phone:201-293-5002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB19121Medicare UPIN