Healthcare Provider Details

I. General information

NPI: 1124253299
Provider Name (Legal Business Name): MR. HENRI ARTHUR BELFON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 CRABTREE BLVD SUITE 107
RALEIGH NC
27604-2296
US

IV. Provider business mailing address

2413 CRABTREE BLVD SUITE 107
RALEIGH NC
27604-2296
US

V. Phone/Fax

Practice location:
  • Phone: 919-899-6740
  • Fax: 919-899-6741
Mailing address:
  • Phone: 919-899-6740
  • Fax: 919-899-6741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: