MEDICARE: MRS. NADEZHDA BELOUS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TUV0066181	NY

General Provider Information

NPI Number	:	1972607547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NADEZHDA BELOUS OD

Provider Business Mailing Address
First Line	:	220 MADISON AVE
Second Line	:	ROSENBLUM EYE CENTERS
City	:	NEW YORK
State	:	NY
Zip	:	10016-3422
Country	:	US
Telephone Number	:	212-683-7330
Fax Number	:	212-683-1947

Provider Business Practice Location Address
First Line	:	220 MADISON AVE
Second Line	:	ROSENBLUM EYE CENTERS
City	:	NEW YORK CITY
State	:	NY
Zip	:	10016-3422
Country	:	US
Telephone Number	:	212-683-7330
Fax Number	:	212-683-1947

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	04/15/2009

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