Individual provider Active NPI

Mor Balaban, L.AC

  • Acupuncturist
  • Tenafly, NJ
National Provider Identifier
1790807196
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
003498-1 Issued in NY
Practice address
183 Riveredge Rd
Tenafly, NJ 07670-1926
Phone
(917) 541-1432
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 003498-1 NY Primary
Acupuncturist 171100000X 25MZ00058700 NJ

Addresses

Primary practice location

183 Riveredge Rd
Tenafly, NJ 07670-1926

Mailing address

183 Riveredge Rd
Tenafly, NJ 07670-1926
Phone (917) 541-1432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MZ00058700NJMDAcupuncturist
003498-1NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1790807196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 RIVEREDGE RD",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701926",
            "telephone_number": "917-541-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 RIVEREDGE RD",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701926",
            "telephone_number": "917-541-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALABAN",
        "first_name": "MOR",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "003498-1",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00058700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tenafly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.