Healthcare Provider Details

I. General information

NPI: 1073271003
Provider Name (Legal Business Name): BELMA MARKISIC NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E 77TH ST
NEW YORK NY
10075-1851
US

IV. Provider business mailing address

9201 SHORE RD APT D304
BROOKLYN NY
11209-6558
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF348906-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: