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General NPI Number Information
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NPI Number | 1245492719
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Entity Type | Organization
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Legal Business Name | CHANDLER ENDOCRINOLOGY, LLC
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 485 S DOBSON RD 115
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City | CHANDLER
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State | AZ
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Zip | 85224-5602
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Country | US
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Telephone | 480-899-0350
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Fax | 480-899-0351
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Provider Business Mailing Address
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Address Line | 485 S DOBSON RD 115
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City | CHANDLER
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State | AZ
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Zip | 85224-5602
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Country | US
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Telephone | 480-899-0350
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Fax | 480-899-0351
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Authorized Official
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Title or Position | PROPRIETOR
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Name | LYUBA BELITSKY
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Credential | MD
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Telephone | 480-899-0350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 35776
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License Number State | AZ
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