Provider Demographics
NPI:1710024955
Name:COLON, BELKIS A (MD)
Entity Type:Individual
Prefix:MRS
First Name:BELKIS
Middle Name:A
Last Name:COLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1700
Mailing Address - Country:US
Mailing Address - Phone:917-645-8663
Mailing Address - Fax:914-513-3486
Practice Address - Street 1:481 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6360
Practice Address - Country:US
Practice Address - Phone:914-595-6882
Practice Address - Fax:914-513-3486
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224174208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02269730Medicaid