Provider Demographics
NPI:1881699528
Name:BELOV, KHATUNA TOPADZE (MD)
Entity type:Individual
Prefix:DR
First Name:KHATUNA
Middle Name:TOPADZE
Last Name:BELOV
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:127 UNION ST
Mailing Address - Street 2:STE 102
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4436
Mailing Address - Country:US
Mailing Address - Phone:201-445-0033
Mailing Address - Fax:201-857-0453
Practice Address - Street 1:127 UNION ST
Practice Address - Street 2:STE 102
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4436
Practice Address - Country:US
Practice Address - Phone:201-857-0066
Practice Address - Fax:201-857-5038
Is Sole Proprietor?:No
Enumeration Date:2005-06-18
Last Update Date:2023-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07761000208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094513WC0Medicare PIN