Healthcare Provider Details

I. General information

NPI: 1467921981
Provider Name (Legal Business Name): ALEJANDRO A BELISTRI FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E PUTNAM AVE
GREENWICH CT
06830-5429
US

IV. Provider business mailing address

337 N BENSON RD
FAIRFIELD CT
06824-5131
US

V. Phone/Fax

Practice location:
  • Phone: 203-658-6051
  • Fax:
Mailing address:
  • Phone: 203-331-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7059
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: