Healthcare Provider Details

I. General information

NPI: 1003041757
Provider Name (Legal Business Name): NICOLE STEPHANIE BELKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 S RIVERSIDE AVE
CROTON ON HUDSON NY
10520-2653
US

IV. Provider business mailing address

2649 STRANG BLVD
YORKTOWN HEIGHTS NY
10598-2939
US

V. Phone/Fax

Practice location:
  • Phone: 914-233-3005
  • Fax: 914-207-1616
Mailing address:
  • Phone: 914-739-0087
  • Fax: 914-737-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT195472
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMT195472
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number278273
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: