MEDICARE: ALYSSA M BELLINO PA-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	363AM0700X	Medical Physician Assistant	PENDING	CT

General Provider Information

NPI Number	:	1528349578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA M BELLINO PA-C

Provider Business Mailing Address
First Line	:	64 BOYDEN RD
Second Line	:
City	:	HOLDEN
State	:	MA
Zip	:	01520-2570
Country	:	US
Telephone Number	:	508-829-6765
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 BOYDEN RD
Second Line	:
City	:	HOLDEN
State	:	MA
Zip	:	01520-2570
Country	:	US
Telephone Number	:	508-829-6765
Fax Number	:

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

Provider Enumeration Date	:	09/05/2011
Last Update Date	:	10/27/2014

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Directions to “ ALYSSA M BELLINO PA-C” Practice Location

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