Provider Demographics
NPI:1487166278
Name:BELLAFLOR, MARIA LESLIE (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LESLIE
Last Name:BELLAFLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6254 97TH PL APT 6O
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1353
Mailing Address - Country:US
Mailing Address - Phone:347-804-8895
Mailing Address - Fax:718-830-0187
Practice Address - Street 1:7136 110TH ST APT 1L
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4860
Practice Address - Country:US
Practice Address - Phone:347-480-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019183225100000X
NY019658-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1538472881OtherNPI