Provider Demographics
NPI:1093809238
Name:BELSKY, MARTIN KARL (DO)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:KARL
Last Name:BELSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BRICK RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2146
Mailing Address - Country:US
Mailing Address - Phone:856-810-7337
Mailing Address - Fax:856-810-7917
Practice Address - Street 1:100 BRICK RD
Practice Address - Street 2:SUITE # 108
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2146
Practice Address - Country:US
Practice Address - Phone:856-810-7337
Practice Address - Fax:856-810-7917
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB04814600207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1224506Medicaid
NJ1224506Medicaid
E53484Medicare UPIN