Provider Demographics
NPI:1750195707
Name:BALANCE360 HEALTH CLINIC
Entity type:Organization
Organization Name:BALANCE360 HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:732-910-7807
Mailing Address - Street 1:1107 CONVERY BLVD
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-1937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1107 CONVERY BLVD
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-1937
Practice Address - Country:US
Practice Address - Phone:732-910-7807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty