Provider Demographics
NPI:1417303744
Name:BELAID, NEDJMA
Entity Type:Individual
Prefix:
First Name:NEDJMA
Middle Name:
Last Name:BELAID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 VILLA RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1246
Mailing Address - Country:US
Mailing Address - Phone:917-485-1311
Mailing Address - Fax:
Practice Address - Street 1:1043 NORTH ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-2701
Practice Address - Country:US
Practice Address - Phone:203-869-2130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0013499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist