Provider Demographics
NPI:1720077373
Name:BELLINA, DANIEL P (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:BELLINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HARRISON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2161
Mailing Address - Country:US
Mailing Address - Phone:607-763-6850
Mailing Address - Fax:607-763-6703
Practice Address - Street 1:30 HARRISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2161
Practice Address - Country:US
Practice Address - Phone:607-763-6850
Practice Address - Fax:607-763-6703
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1863281207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01473041Medicaid
F76337Medicare UPIN
NYDD2818Medicare ID - Type Unspecified
NY4439690001Medicare NSC