Provider Demographics
NPI:1417135674
Name:JEAN-BAPTISTE, BELLANDE (RPH)
Entity Type:Individual
Prefix:MR
First Name:BELLANDE
Middle Name:
Last Name:JEAN-BAPTISTE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4532
Mailing Address - Country:US
Mailing Address - Phone:201-434-7398
Mailing Address - Fax:201-434-7398
Practice Address - Street 1:125 18TH ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1242
Practice Address - Country:US
Practice Address - Phone:201-626-5533
Practice Address - Fax:201-217-0288
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02397300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist