Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 345218 | NY |
N | 363LC1500X | Nurse Practitioner - Community Health | 345218 | NY |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 345218 | NY |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 345218 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | 345218 | NY |
NPI | 1922642941 |
---|---|
Provider Name | Mr. Byren William Bellen |
First Address | Amsterdam, NY 12010-6317 |
Second Address | Amsterdam, NY 12010-6317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2019 |
Last Update Date | 01/11/2019 |