Provider Demographics
NPI:1831238575
Name:DR. MAE J. BALABAN AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:DR. MAE J. BALABAN AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PLASNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-833-0655
Mailing Address - Street 1:1415 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3521
Mailing Address - Country:US
Mailing Address - Phone:201-833-0655
Mailing Address - Fax:201-833-4025
Practice Address - Street 1:1415 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3521
Practice Address - Country:US
Practice Address - Phone:201-833-0655
Practice Address - Fax:201-833-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00519800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty