Provider Demographics
NPI:1912015025
Name:BELLINO, JOSEPH P (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:BELLINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4810
Mailing Address - Country:US
Mailing Address - Phone:401-274-2300
Mailing Address - Fax:401-272-1302
Practice Address - Street 1:830 EDDY STREET
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2403
Practice Address - Country:US
Practice Address - Phone:401-274-2300
Practice Address - Fax:401-272-1302
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3762207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9000093Medicaid
RI007059812OtherMEDICARE PTAN
RI10-21-1938OtherDATE OF BIRTH
RI9000093Medicaid