Organization
BELLARDINI KOSC AND PAVLOU MDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELO G. BELLARDINI MD (PRESIDENT)
(973) 256-5557
Entity
Organization
Contact information
Practice address
1130 MCBRIDE AVENUE, WEST PATERSON, NJ 07424
(973) 256-5557
(973) 256-5036
Mailing address
1130 MCBRIDE AVENUE, WEST PATERSON, NJ 07424
(973) 256-5557
(973) 256-5036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NJ
207R00000X
Internal Medicine Physician
Primary
—
NJ
207RG0100X
Gastroenterology Physician
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0868546
AETNA HMO
NJ
05
—
1039300
—
NJ
01
—
5862571
AETNA PPO
NJ
01
—
CA0181
RAILROAD MEDICARE
NJ
Enumeration date
06/24/2005
Last updated
07/21/2022
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