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General NPI Number Information
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NPI Number | 1841471810
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Entity Type | Organization
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Legal Business Name | JOSEPH DEBELLIS MD PC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 80 SANFORD PL
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-3317
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Country | US
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Telephone | 631-287-1234
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Fax | 631-287-2891
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Provider Business Mailing Address
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Address Line | 80 SANFORD PL
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-3317
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Country | US
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Telephone | 631-287-1234
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Fax | 631-287-2891
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Authorized Official
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Title or Position | DOCTOR
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Name | JOSEPH DEBELLIS
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Credential | MD
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Telephone | 631-287-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 174426
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License Number State | NY
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