Provider Demographics
NPI:1316190432
Name:BELZINCE, MYRLINE ROSE (MD)
Entity type:Individual
Prefix:
First Name:MYRLINE ROSE
Middle Name:
Last Name:BELZINCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 TULSA ST
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1615
Mailing Address - Country:US
Mailing Address - Phone:857-200-7400
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # 8055
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-7829
Practice Address - Fax:504-988-4264
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3226432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry