Provider Demographics
NPI:1831256296
Name:BELZUNCE, PHILIP RUIZ (PHD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:RUIZ
Last Name:BELZUNCE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22380 BERRY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2016
Mailing Address - Country:US
Mailing Address - Phone:440-333-4105
Mailing Address - Fax:440-398-2623
Practice Address - Street 1:22380 BERRY DR
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2016
Practice Address - Country:US
Practice Address - Phone:440-333-4105
Practice Address - Fax:440-398-2623
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3230103TC1900X
OHF.0000133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH249995OtherPSYCHOLOGIST