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NPI Code Detail

MEDICARE: THOMAS SALVATORE BELLAVIA MD

MEDICARE:   THOMAS SALVATORE BELLAVIA  MD
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
1207Q00000XFamily Medicine Physician21636NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750347449
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS SALVATORE BELLAVIA MD
Provider Business Mailing Address
First Line : 288 BOULEVARD STE 2
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-1319
Country : US
Telephone Number : 201-288-6781
Fax Number : 201-288-2734
Provider Business Practice Location Address
First Line : 288 BOULEVARD STE 2
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-1319
Country : US
Telephone Number : 201-288-6781
Fax Number : 201-288-2734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2006
Last Update Date : 05/14/2019

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Directions to “ THOMAS SALVATORE BELLAVIA MD” Practice Location

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