MEDICARE: PROF. TERRANCE J. BELLNIER R.PH., MPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835G0303X	Geriatric Pharmacist	031491	NY
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	031491	NY
3	1835P1300X	Psychiatric Pharmacist	031491	NY
4	1835P1200X	Pharmacotherapy Pharmacist	031491	NY

General Provider Information

NPI Number	:	1265671804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. TERRANCE J. BELLNIER R.PH., MPA

Provider Business Mailing Address
First Line	:	36 FOREST MEADOW TRL
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1154
Country	:	US
Telephone Number	:	585-739-5880
Fax Number	:	585-663-9088

Provider Business Practice Location Address
First Line	:	1597 RIDGE RD W
Second Line	:	SUITE 302
City	:	ROCHESTER
State	:	NY
Zip	:	14615-2513
Country	:	US
Telephone Number	:	585-730-6113
Fax Number	:	585-730-6112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2009
Last Update Date	:	01/10/2015

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