Healthcare Provider Details
I. General information
NPI: 1598478182
Provider Name (Legal Business Name): BELONG MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2022
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
625 STATE ST
SCHENECTADY NY
12305-2111
US
IV. Provider business mailing address
6614 AVE. U PMB 98846
BROOKLYN NY
11234-6021
US
V. Phone/Fax
- Phone: 910-987-3272
- Fax:
- Phone: 910-987-3272
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JORDAN
ANDERSON
Title or Position: PRESIDENT
Credential: MD
Phone: 910-987-3272