Provider Demographics
NPI:1427692995
Name:BELEM, MAHAMADI
Entity type:Individual
Prefix:
First Name:MAHAMADI
Middle Name:
Last Name:BELEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2474 VALENTINE AVE APT C21
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5335
Mailing Address - Country:US
Mailing Address - Phone:917-688-5087
Mailing Address - Fax:
Practice Address - Street 1:2474 VALENTINE AVE APT C21
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5335
Practice Address - Country:US
Practice Address - Phone:917-688-5087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY628244-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health