| Dr. Bellamy Brook Do Pc | |
|
300 Old Country Rd Ste 2 Riverhead NY 11901-2146 | |
| (631) 405-5544 | |
| Not Available |
| Full Name | Dr. Bellamy Brook Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 300 Old Country Rd Ste 2, Riverhead, New York |
| Authorized Official Name and Position | Bellamy Brook (PHYSICIAN) |
| Authorized Official Contact | 6319983434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Bellamy Brook Do Pc 300 Old Country Rd Ste 2 Riverhead NY 11901-2146 Ph: (631) 405-5544 | Dr. Bellamy Brook Do Pc 300 Old Country Rd Ste 2 Riverhead NY 11901-2146 Ph: (631) 405-5544 |
| NPI Number | 1609013580 |
|---|---|
| Provider Enumeration Date | 01/14/2009 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 6901957372 |
|---|---|
| Medicare Enrollment ID | O20090624000485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609013580 | NPI | - | NPPES |
| 215053-1 | Other | NY | STATE PROFESSIONAL LICENSE |
| 11541228 | Other | NY | CAQH ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 215053-1 (New York) | Primary |
| Provider Name | Bellamy C Brook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477511749 PECOS PAC ID: 2163489535 Enrollment ID: I20041216001032 |
| Provider Name | Judith M Magloczki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801240064 PECOS PAC ID: 2264769868 Enrollment ID: I20200722003191 |
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