1912044702 NPI number — MRS. KELLY BELINSKY MS,OTRL

Table of content: MRS. KELLY BELINSKY MS,OTRL (NPI 1912044702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912044702 NPI number — MRS. KELLY BELINSKY MS,OTRL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELINSKY
Provider First Name:
KELLY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS,OTRL
Provider Gender Code:
F

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:
1912044702
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
237 STRASSER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTWOOD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02090-2030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-461-2414
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1330 BEACON ST
Provider Second Line Business Practice Location Address:
SUITE 221
Provider Business Practice Location Address City Name:
BROOKLINE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02446-3282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-277-1550
Provider Business Practice Location Address Fax Number:
781-329-2805
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  2537 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 41151 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: OT0059 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 666828 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com