Provider Demographics
NPI:1447625645
Name:BELPANNO, KATHERINE
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:BELPANNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 33RD ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3238
Mailing Address - Country:US
Mailing Address - Phone:516-810-6475
Mailing Address - Fax:
Practice Address - Street 1:209 33RD ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-3238
Practice Address - Country:US
Practice Address - Phone:516-810-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist