Provider Demographics
NPI:1649413634
Name:BELLANTI, PATRICE ANN (MD)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:ANN
Last Name:BELLANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 BRADENTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3511
Mailing Address - Country:US
Mailing Address - Phone:380-214-1636
Mailing Address - Fax:903-487-0600
Practice Address - Street 1:5060 BRADENTON AVE STE A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3511
Practice Address - Country:US
Practice Address - Phone:380-214-1636
Practice Address - Fax:903-487-0600
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1213782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry