Healthcare Provider Details

I. General information

NPI: 1992023089
Provider Name (Legal Business Name): PUNEET B BELANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3548 ROUTE 9
OLD BRIDGE NJ
08857-2765
US

IV. Provider business mailing address

PO BOX 3263
INDIANAPOLIS IN
46206-3263
US

V. Phone/Fax

Practice location:
  • Phone: 732-970-0420
  • Fax: 732-970-0517
Mailing address:
  • Phone: 844-362-6808
  • Fax: 844-297-6313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA09833700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: