Provider Demographics
NPI:1265800841
Name:BELLAMY, MARIAMMA (RN)
Entity type:Individual
Prefix:MRS
First Name:MARIAMMA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BARR LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4939
Mailing Address - Country:US
Mailing Address - Phone:347-409-1324
Mailing Address - Fax:
Practice Address - Street 1:80 BARR LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4939
Practice Address - Country:US
Practice Address - Phone:347-409-1324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-13
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY599991163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse