Organization
BALANCED WELL MEDICAL NETWORK
Active
Parent organization
BALANCED WELL MEDICAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
BALANCED WELL MEDICAL
Authorized official
DR. ROTH LEON RILEY MD (DIRECTOR)
(201) 794-4500
Entity
Organization
Contact information
Practice address
23-08 MAPLE AVE, FAIR LAWN, NJ 07410-1583
(201) 794-4500
(201) 794-4502
Mailing address
23-08 MAPLE AVE, FAIR LAWN, NJ 07410-1583
(201) 794-4500
(201) 794-4502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA09551100
NJ
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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