Provider Demographics
NPI:1588976401
Name:ANTHONY BELO PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:ANTHONY BELO PHYSICAL THERAPY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-307-1515
Mailing Address - Street 1:23 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2357
Mailing Address - Country:US
Mailing Address - Phone:516-307-1515
Mailing Address - Fax:516-307-1514
Practice Address - Street 1:23 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2357
Practice Address - Country:US
Practice Address - Phone:516-307-1515
Practice Address - Fax:516-307-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295251261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy