=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427364603
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN A. BELINKIE, M.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2010
-----------------------------------------------------
Last Update Date | 08/25/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1000 ASYLUM AVE SUITE 2107
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06105-1709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-278-3774
-----------------------------------------------------
Fax | 860-714-8444
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1000 ASYLUM AVE SUITE 2107
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06105-1709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-278-3774
-----------------------------------------------------
Fax | 860-714-8444
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. STEVEN A BELINKIE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 860-278-3774
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0122X
-----------------------------------------------------
Taxonomy Name | Plastic and Reconstructive Surgery Physician
-----------------------------------------------------
License Number | 022522
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------