Healthcare Provider Details

I. General information

NPI: 1487880738
Provider Name (Legal Business Name): ALYCE VICTORIA BELONIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 4006
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE MLC 4006
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4760
  • Fax: 513-636-7297
Mailing address:
  • Phone: 513-636-4760
  • Fax: 513-636-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number01077193A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01077193A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number35.134853
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.134853
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-17749
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: