Provider Demographics
NPI:1912021361
Name:BELLIS, PETER WILLIAM (NA)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:WILLIAM
Last Name:BELLIS
Suffix:
Gender:M
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 BITTERSWEET DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2771
Mailing Address - Country:US
Mailing Address - Phone:800-828-7711
Mailing Address - Fax:717-657-9088
Practice Address - Street 1:4230 CRUMS MILL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2898
Practice Address - Country:US
Practice Address - Phone:800-828-7711
Practice Address - Fax:717-657-9088
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANA246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PANAOtherVENDOR SALES REP.