Healthcare Provider Details

I. General information

NPI: 1720077373
Provider Name (Legal Business Name): DANIEL P BELLINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HARRISON ST SUITE 100
JOHNSON CITY NY
13790-2161
US

IV. Provider business mailing address

30 HARRISON ST SUITE 100
JOHNSON CITY NY
13790-2161
US

V. Phone/Fax

Practice location:
  • Phone: 607-763-6850
  • Fax: 607-763-6703
Mailing address:
  • Phone: 607-763-6850
  • Fax: 607-763-6703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number1863281
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: