Provider Demographics
NPI:1922176338
Name:BELKIN, BARTON (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTON
Middle Name:
Last Name:BELKIN
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 1:2060 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3552
Mailing Address - Country:US
Mailing Address - Phone:203-384-8248
Mailing Address - Fax:203-336-1228
Practice Address - Street 1:2060 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3552
Practice Address - Country:US
Practice Address - Phone:203-384-8248
Practice Address - Fax:203-336-1228
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026879174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001268798Medicaid
CT110001384Medicare ID - Type Unspecified
CT001268798Medicaid