Provider Demographics
NPI:1447273693
Name:BELLIZZI, PETER V (DC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:V
Last Name:BELLIZZI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1818
Mailing Address - Country:US
Mailing Address - Phone:732-745-4888
Mailing Address - Fax:732-249-2666
Practice Address - Street 1:44 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850-1818
Practice Address - Country:US
Practice Address - Phone:732-745-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0099737000OtherAMERIHEALTH
NJ1970704Medicaid
NJ1970704Medicaid