Provider Demographics
NPI:1114995982
Name:BELSKY, IRENE A (MD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:A
Last Name:BELSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IRINA
Other - Middle Name:ARNOLDOVNA
Other - Last Name:GENKINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-5312
Mailing Address - Country:US
Mailing Address - Phone:508-543-6371
Mailing Address - Fax:508-543-3347
Practice Address - Street 1:70 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-5312
Practice Address - Country:US
Practice Address - Phone:508-543-6371
Practice Address - Fax:508-543-3347
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA3811901OtherMEDICARE PTAN
MA2169703Medicaid
RIIB77512Medicaid
MAA3811901OtherMEDICARE PTAN