Healthcare Provider Details

I. General information

NPI: 1275651366
Provider Name (Legal Business Name): DAVID JOHN BELFANTI LPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PENN AVE GINO MERLI VETERANS CENTER
SCRANTON PA
18503
US

IV. Provider business mailing address

2840 FRINK ST
SCRANTON PA
18504-1002
US

V. Phone/Fax

Practice location:
  • Phone: 570-961-4360
  • Fax:
Mailing address:
  • Phone: 570-969-6198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT003832L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: