Provider Demographics
NPI:1407280506
Name:BELKO, ANNE K (LMT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:K
Last Name:BELKO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W CLEMENTS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RUNNEMEDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08078-1925
Mailing Address - Country:US
Mailing Address - Phone:856-904-0142
Mailing Address - Fax:856-853-0166
Practice Address - Street 1:615 W CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1925
Practice Address - Country:US
Practice Address - Phone:856-939-6663
Practice Address - Fax:856-939-1182
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00512700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist