MEDICARE: BELINDA A MARQUIS,MD,PC

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	166813	NY

General Provider Information

NPI Number	:	1639460041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELINDA A MARQUIS,MD,PC

Provider Business Mailing Address
First Line	:	1543 STRAIGHT PATH
Second Line	:
City	:	WYANDANCH
State	:	NY
Zip	:	11798-3415
Country	:	US
Telephone Number	:	631-643-6006
Fax Number	:	631-920-6047

Provider Business Practice Location Address
First Line	:	1543 STRAIGHT PATH
Second Line	:
City	:	WYANDANCH
State	:	NY
Zip	:	11798-3415
Country	:	US
Telephone Number	:	631-643-6006
Fax Number	:	631-643-7026

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BELINDA AGHARESE MARQUIS
Credential	:	MD
Telephone Number	:	631-643-6006

Provider Enumeration Date	:	04/20/2011
Last Update Date	:	08/06/2013

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