Provider Demographics
NPI:1245536143
Name:BELIMAC, ROWENA C (QA)
Entity type:Individual
Prefix:MS
First Name:ROWENA
Middle Name:C
Last Name:BELIMAC
Suffix:
Gender:F
Credentials:QA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 SEABURY ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5303 SEABURY ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4443
Practice Address - Country:US
Practice Address - Phone:646-637-1654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY614426251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health