Provider Demographics
NPI:1508051632
Name:BELANGER, MARY ANNE N (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY ANNE
Middle Name:N
Last Name:BELANGER
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 1:123 N WHITE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531-5412
Mailing Address - Country:US
Mailing Address - Phone:845-855-9338
Mailing Address - Fax:
Practice Address - Street 1:123 N WHITE ROCK RD
Practice Address - Street 2:
Practice Address - City:HOLMES
Practice Address - State:NY
Practice Address - Zip Code:12531-5412
Practice Address - Country:US
Practice Address - Phone:845-855-9338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3309721163W00000X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0600XNursing Service ProvidersRegistered NurseGerontology