1093769598 NPI number — PAUL I BELITZ DPM PC

Table of content: MR. PETER D HAYWARD M.D. (NPI 1477518009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093769598 NPI number — PAUL I BELITZ DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAUL I BELITZ DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093769598
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 FIREMANS MEMORIAL DR
Provider Second Line Business Mailing Address:
SUITE 111
Provider Business Mailing Address City Name:
POMONA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10970-3553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-354-2600
Provider Business Mailing Address Fax Number:
845-354-2637

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26 FIREMANS MEMORIAL DR
Provider Second Line Business Practice Location Address:
SUITE 111
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10970-3553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-354-2600
Provider Business Practice Location Address Fax Number:
845-354-2637
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BELITZ
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
I
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
845-354-2600

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  N0055261-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000237207504 . This is a "UNITED HEALTHCARE EMPIRE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3557460 . This is a "AETNA US HEALTHCARE HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7127482 . This is a "AETNA US HEALTHCARE PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 713689 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2275932 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: PK2701 . This is a "EMPIRE BLUECROSS/BLUESHIE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 55260 . This is a "CONNECTICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8888996 . This is a "CIGNA" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: P12041706 . This is a "MULTIPLAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 2372075 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 292389C . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2973570 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5C4281 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10105253 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 60317000010 . This is a "FIDELIS CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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