MEDICARE: ANATOLY BELILOVSKY MD PLLC

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	208000000X	Pediatrics Physician	176593	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366697476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANATOLY BELILOVSKY MD PLLC

Provider Business Mailing Address
First Line	:	690 BAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-3830
Country	:	US
Telephone Number	:	718-815-7050
Fax Number	:	718-815-4889

Provider Business Practice Location Address
First Line	:	690 BAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-3830
Country	:	US
Telephone Number	:	718-815-7050
Fax Number	:	718-815-4889

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ANATOLY BELILOVSKY
Credential	:	MD
Telephone Number	:	718-815-7050

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	11/18/2008

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