Provider Demographics
NPI:1285623595
Name:BELMONT, JUDSON R (MD)
Entity type:Individual
Prefix:DR
First Name:JUDSON
Middle Name:R
Last Name:BELMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:130 TARRYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2713
Mailing Address - Country:US
Mailing Address - Phone:603-669-0831
Mailing Address - Fax:603-669-4088
Practice Address - Street 1:130 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2713
Practice Address - Country:US
Practice Address - Phone:603-669-0831
Practice Address - Fax:603-669-4088
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7535207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30001934Medicaid
NHBENH9363Medicare ID - Type Unspecified
NH30001934Medicaid