Provider Demographics
NPI:1144594276
Name:BELLE, PHYLLIS L (RN)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:L
Last Name:BELLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 101ST ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1109
Mailing Address - Country:US
Mailing Address - Phone:718-850-2186
Mailing Address - Fax:718-850-2186
Practice Address - Street 1:8440 101ST ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1109
Practice Address - Country:US
Practice Address - Phone:718-850-2186
Practice Address - Fax:718-850-2186
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY388401-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse