Healthcare Provider Details

I. General information

NPI: 1235498064
Provider Name (Legal Business Name): BRANDIS BELT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 REHILL AVE
SOMERVILLE NJ
08876-2519
US

IV. Provider business mailing address

379 CAMPUS DR FL 4
SOMERSET NJ
08873-1161
US

V. Phone/Fax

Practice location:
  • Phone: 908-685-2900
  • Fax: 732-463-5512
Mailing address:
  • Phone: 732-937-8939
  • Fax: 732-418-8372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number272986
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA10132200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: