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General NPI Number Information
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NPI Number | 1881699528
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Entity Type | Individual
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Provider Name | KHATUNA TOPADZE BELOV MD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2005
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 127 UNION ST STE 102
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4436
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Country | US
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Telephone | 201-857-0066
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Fax | 201-857-5038
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Provider Business Mailing Address
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Address Line | 127 UNION ST STE 102
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4436
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Country | US
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Telephone | 201-445-0033
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Fax | 201-857-0453
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA07761000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA07761000
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License Number State | NJ
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