NPI 1295181584

Balanced Well Medical Network

Organisation Family Medicine Physician Fair Lawn, NJ

Practice location

Address: 23-08 Maple Ave, Fair Lawn, NJ 07410-1583
Phone: (201) 794-4500
Fax: (201) 794-4502

Authorised official

Name: Roth Leon Riley
Title: Director
Phone: (201) 794-4500

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 25MA09551100 (NJ)

Other Family Medicine providers in New Jersey →

Registry record

NPI: 1295181584
Entity type: Organization
NPI issued: 5 May 2016
Record last updated: 5 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.