Provider Demographics
NPI:1134335110
Name:PHILIP R BELZUNCE PHD INC
Entity type:Organization
Organization Name:PHILIP R BELZUNCE PHD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:RUIZ
Authorized Official - Last Name:BELZUNCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PSYCHOLOGIST
Authorized Official - Phone:440-333-4105
Mailing Address - Street 1:22380 BERRY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2016
Mailing Address - Country:US
Mailing Address - Phone:440-333-4105
Mailing Address - Fax:440-398-2623
Practice Address - Street 1:22380 BERRY DR
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2016
Practice Address - Country:US
Practice Address - Phone:440-333-4105
Practice Address - Fax:440-398-2623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3238103T00000X
OH3230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty