Provider Demographics
NPI:1861438681
Name:BELZIE, LOUIS R (MD, PHD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:R
Last Name:BELZIE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8806 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3414
Mailing Address - Country:US
Mailing Address - Phone:347-295-2812
Mailing Address - Fax:347-295-2813
Practice Address - Street 1:8806 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3414
Practice Address - Country:US
Practice Address - Phone:347-295-2812
Practice Address - Fax:347-295-2813
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1943262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2540193OtherAETNA US HEALTHCARE
NY6012079OtherGHI
NY370010480OtherHEALTHPLUS
NY01681516Medicaid
NY194326-A41OtherHEALTHFIRST
NY900280701OtherAMERICHOICE
NY900280701OtherAMERICHOICE
NY2540193OtherAETNA US HEALTHCARE