Provider Demographics
NPI:1598801557
Name:BELFIORE, MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BELFIORE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 MERRICK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4786
Mailing Address - Country:US
Mailing Address - Phone:516-371-5800
Mailing Address - Fax:516-371-3712
Practice Address - Street 1:2209 MERRICK ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4770
Practice Address - Country:US
Practice Address - Phone:516-371-5800
Practice Address - Fax:516-371-3712
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2108776Medicaid
NY2108776Medicaid
G23602Medicare UPIN