Provider Demographics
NPI:1821309121
Name:BELFON, AIMEE M (CRNA)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:M
Last Name:BELFON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:M
Other - Last Name:PELUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 650782
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0782
Mailing Address - Country:US
Mailing Address - Phone:888-709-4485
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:175 E CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2284
Practice Address - Country:US
Practice Address - Phone:610-595-6000
Practice Address - Fax:877-329-2370
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0037182163W00000X
DEL6-0A00609367500000X
PARN580906367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
086581OtherAANA ID#