Provider Demographics
NPI:1821238411
Name:CLUTARIO, BELLA C (MD)
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:C
Last Name:CLUTARIO
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 1:133 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-2730
Mailing Address - Country:US
Mailing Address - Phone:845-359-3728
Mailing Address - Fax:845-359-3728
Practice Address - Street 1:133 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-2730
Practice Address - Country:US
Practice Address - Phone:845-359-3728
Practice Address - Fax:845-359-3728
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132172174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist