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General NPI Number Information
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NPI Number | 1194721746
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Entity Type | Individual
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Provider Name | JAY P BELLIAS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 404 TATUM ST
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City | WOODBURY
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State | NJ
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Zip | 08096-3499
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Country | US
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Telephone | 856-845-8050
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Fax |
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Provider Business Mailing Address
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Address Line | 404 TATUM ST
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City | WOODBURY
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State | NJ
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Zip | 08096-3499
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Country | US
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Telephone | 856-845-8050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MB06322800
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License Number State | NJ
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