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General NPI Number Information
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NPI Number | 1811076169
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Entity Type | Individual
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Provider Name | PASQUALE J BILELLO D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 6534 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-6250
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Country | US
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Telephone | 516-627-0993
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Fax |
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Provider Business Mailing Address
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Address Line | 65-34 MYRTLE AVENUE
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City | GLENDALE
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State | NY
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Zip | 11385
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Country | US
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Telephone | 516-627-0993
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 028211
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License Number State | NY
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