Provider Demographics
NPI:1669752580
Name:BELLISTRI, JOHN-PAUL SALVATORE (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN-PAUL
Middle Name:SALVATORE
Last Name:BELLISTRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22104 CORBETT RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2243
Mailing Address - Country:US
Mailing Address - Phone:917-217-2425
Mailing Address - Fax:
Practice Address - Street 1:22104 CORBETT RD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2243
Practice Address - Country:US
Practice Address - Phone:917-217-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283720208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery