Provider Demographics
NPI:1881807014
Name:BALANCE INVALID COACH,INC.
Entity type:Organization
Organization Name:BALANCE INVALID COACH,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GAMAL
Authorized Official - Middle Name:E
Authorized Official - Last Name:YAHYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-332-1127
Mailing Address - Street 1:1215 LIBERTY AVE
Mailing Address - Street 2:SUITE# 27
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2054
Mailing Address - Country:US
Mailing Address - Phone:973-332-1127
Mailing Address - Fax:973-395-2724
Practice Address - Street 1:1215 LIBERTY AVE
Practice Address - Street 2:SUITE# 27
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2054
Practice Address - Country:US
Practice Address - Phone:973-332-1127
Practice Address - Fax:973-395-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ7687206343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ073471198072050OtherCORPORATION