MEDICARE: BELKIN MEDICAL P.C.

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	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	211991	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	:	1487720553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELKIN MEDICAL P.C.

Provider Business Mailing Address
First Line	:	47 7TH AVE
Second Line	:	#3
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3612
Country	:	US
Telephone Number	:	718-222-0333
Fax Number	:	718-222-0577

Provider Business Practice Location Address
First Line	:	207 BERKELEY PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3801
Country	:	US
Telephone Number	:	646-251-1164
Fax Number	:	718-398-7298

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. REGINA BELKIN
Credential	:	M.D.
Telephone Number	:	646-251-1164

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	06/02/2011

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