Provider Demographics
NPI:1679311567
Name:BELLANIE, STEVEN JOHN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JOHN
Last Name:BELLANIE
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 1:3226 203RD ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1020
Mailing Address - Country:US
Mailing Address - Phone:347-551-9270
Mailing Address - Fax:
Practice Address - Street 1:3226 203RD ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1020
Practice Address - Country:US
Practice Address - Phone:347-551-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant