Stamford Balance, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001940 Issued in CT

Legal business name

STAMFORD BALANCE, LLC

Practice address

144 Morgan St
Suite 2
Stamford, CT 06905-5433

Phone

(203) 355-2830

Fax

(203) 405-8848

NPI assigned

Mar 27, 2015

Last updated

Mar 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cristina Poulos, DC

Title

Owner

Phone

(203) 355-2830

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1942694823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 MORGAN ST",
            "address_2": "SUITE 2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055433",
            "telephone_number": "203-355-2830",
            "fax_number": "203-405-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 MORGAN ST",
            "address_2": "SUITE 2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055433",
            "telephone_number": "203-355-2830",
            "fax_number": "203-405-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMFORD BALANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "POULOS",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-355-2830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Stamford, CT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.