Provider Demographics
NPI:1649347295
Name:BEZPALKO, OREST (DO)
Entity type:Individual
Prefix:DR
First Name:OREST
Middle Name:
Last Name:BEZPALKO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 NAUTILUS DR
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2448
Mailing Address - Country:US
Mailing Address - Phone:609-597-0321
Mailing Address - Fax:609-597-0014
Practice Address - Street 1:77 NAUTILUS DR
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2448
Practice Address - Country:US
Practice Address - Phone:609-597-0321
Practice Address - Fax:609-597-0014
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05823500207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD05820800OtherCDS
NJBB7029665OtherDEA
NJD05820800OtherCDS
NJF13972Medicare UPIN