Healthcare Provider Details
I. General information
NPI: 1750373171
Provider Name (Legal Business Name): SERGEI NAUM BELENKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 08/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9000 PERRY HWY SUITE 320
PITTSBURGH PA
15237-5367
US
IV. Provider business mailing address
1100 WASHINGTON AVE SUITE 215
CARNEGIE PA
15106-3614
US
V. Phone/Fax
- Phone: 412-348-6868
- Fax: 412-366-5118
- Phone: 412-278-3310
- Fax: 412-278-3320
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | MD063489L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: