Provider Demographics
NPI:1518233915
Name:BELSKY, SUSAN R
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:BELSKY
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 1:500 DISCOVERY PKWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8639
Mailing Address - Country:US
Mailing Address - Phone:303-926-8734
Mailing Address - Fax:303-926-8747
Practice Address - Street 1:500 DISCOVERY PKWY
Practice Address - Street 2:SUITE 125
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8639
Practice Address - Country:US
Practice Address - Phone:303-926-8734
Practice Address - Fax:303-926-8747
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO114246246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO114246OtherNATIONAL BOARD OF SURGICAL TECHNOLOGY