MEDICARE: DR. EVE LIBBY BELECEN D.D.S.

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	122300000X	Dentist	057905-1	NY
2	390200000X	Student in an Organized Health Care Education/Training Program

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	:	1487064911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVE LIBBY BELECEN D.D.S.

Provider Business Mailing Address
First Line	:	10225 67TH DR
Second Line	:	APT 5R
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2860
Country	:	US
Telephone Number	:	516-729-1448
Fax Number	:

Provider Business Practice Location Address
First Line	:	10225 67TH DR
Second Line	:	APT 5R
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2860
Country	:	US
Telephone Number	:	516-729-1448
Fax Number	:

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

Provider Enumeration Date	:	05/06/2014
Last Update Date	:	02/29/2016

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