MEDICARE: CHRISTINE BELUSKO MSR-OTR/L

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	225XP0200X	Pediatric Occupational Therapist	3210	GA

General Provider Information

NPI Number	:	1588657530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE BELUSKO MSR-OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 71894
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31708-1894
Country	:	US
Telephone Number	:	229-349-0809
Fax Number	:	229-446-8945

Provider Business Practice Location Address
First Line	:	2010 CUMBERLAND LN
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-2145
Country	:	US
Telephone Number	:	122-944-6894
Fax Number	:	122-944-6894

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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