Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000449 | CT |
NPI | 1093017592 |
---|---|
Provider Name | Dr. Jason M Belejack |
First Address | Cheshire, CT 06410-2540 |
Second Address | Cheshire, CT 06410-2540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 03/12/2010 |