1639109796 NPI number — ANDREI BELSKY M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639109796 NPI number — ANDREI BELSKY M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BELSKY

Provider First Name:

ANDREI

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1639109796

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/12/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 8500-6335

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

PHILADELPHIA

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

19178-0001

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

215-807-8000

Provider Business Mailing Address Fax Number:

215-807-8235

Provider First Line Business Practice Location Address:

3998 RED LION RD

Provider Second Line Business Practice Location Address:

ANESTHESIA DEPARTMENT

Provider Business Practice Location Address City Name:

PHILADELPHIA

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

19114-1436

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

215-612-4088

Provider Business Practice Location Address Fax Number:

215-612-4323

Provider Enumeration Date:

07/04/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207L00000X , with the licence number:  MD417813 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 0018819290004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1342871 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 30020599 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 4245761 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2035568000 . This is a "KEYSTONE IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0018819290006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 01881929-04 . This is a "AMERICHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1342871 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0018819290005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 01697T,30563F . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: P00239045 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".