Provider Demographics
NPI:1275059073
Name:BELLOIR, JOSEPH ALLEN (PHD, MSC, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALLEN
Last Name:BELLOIR
Suffix:
Gender:M
Credentials:PHD, MSC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 42ND ST APT S42L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-2051
Mailing Address - Country:US
Mailing Address - Phone:929-487-3535
Mailing Address - Fax:424-500-6217
Practice Address - Street 1:620 W 42ND ST APT S42L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-2051
Practice Address - Country:US
Practice Address - Phone:929-487-3535
Practice Address - Fax:424-500-6217
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402325363LP0808X, 363LP0808X
NY740839163W00000X
MARN2310536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse