Provider Demographics
NPI:1518182757
Name:BELIZAR, ROBERT STANLEY (PT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STANLEY
Last Name:BELIZAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WILLOW POND LN
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1540
Mailing Address - Country:US
Mailing Address - Phone:631-928-3402
Mailing Address - Fax:631-928-6964
Practice Address - Street 1:14 WILLOW POND LN
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-1540
Practice Address - Country:US
Practice Address - Phone:631-928-3402
Practice Address - Fax:631-928-6964
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist