Provider Demographics
NPI:1124009048
Name:BELMONT, JEFFFREY HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFFREY
Middle Name:HOWARD
Last Name:BELMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5023
Mailing Address - Country:US
Mailing Address - Phone:646-345-7073
Mailing Address - Fax:
Practice Address - Street 1:41 LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5023
Practice Address - Country:US
Practice Address - Phone:212-517-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155995207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00826224Medicaid
NY00826224Medicaid
NY11D431Medicare ID - Type Unspecified