Provider Demographics
NPI:1972824530
Name:BELLANTONI, MARC (DC)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:BELLANTONI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 BABYLON ST
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-4501
Mailing Address - Country:US
Mailing Address - Phone:516-445-1166
Mailing Address - Fax:
Practice Address - Street 1:2413 BABYLON ST
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-4501
Practice Address - Country:US
Practice Address - Phone:516-445-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor