Provider Demographics
NPI:1649445701
Name:BELESIS, ANASTASIA P
Entity type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:P
Last Name:BELESIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1837
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10925-1837
Mailing Address - Country:US
Mailing Address - Phone:845-477-8024
Mailing Address - Fax:845-477-8484
Practice Address - Street 1:123 WINDMERE AVENUE
Practice Address - Street 2:
Practice Address - City:GREENWOOD LAKE
Practice Address - State:NY
Practice Address - Zip Code:10925-1837
Practice Address - Country:US
Practice Address - Phone:845-477-8024
Practice Address - Fax:845-477-8484
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist