Vital Balance Osteopathy, PLLC

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

Legal business name

VITAL BALANCE OSTEOPATHY, PLLC

Practice address

10 Bond Street
Ste 1, #290
Great Neck, NY 11021

Phone

(917) 338-1884

NPI assigned

Sep 14, 2020

Organization subpart

Yes

Parent organization

VITAL BALANCE OSTEOPATHY, PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lisa Preston, DONPI 1194843292

Title

Owner, Presiden, Physician

Phone

(917) 338-1884

Specialties & licenses 2

Addresses

Part of

Vital Balance Osteopathy PLLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Meredith Preston, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • New York, NY
  • NPI 1194843292
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1760097927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BOND STREET",
            "address_2": "STE 1, #290",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "917-338-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BOND STREET",
            "address_2": "STE 1, #290",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "917-338-1884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 W 35th St Ste 1400",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100012530",
            "country_code": "US",
            "telephone_number": "917-338-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITAL BALANCE OSTEOPATHY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VITAL BALANCE OSTEOPATHY, PLLC",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER, PRESIDEN, PHYSICIAN",
        "authorized_official_telephone_number": "917-338-1884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neuromusculoskeletal Medicine & OMM Physician in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Neuromusculoskeletal Medicine & OMM Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.