Individual
WAYNE JOHN BELLUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
47 COMMERCE AVE STE 1, RIVERHEAD, NY 11901-3106
(631) 978-7633
(631) 638-4884
Mailing address
500 COMMACK RD UNIT 206, COMMACK, NY 11725-5022
(631) 675-2125
(631) 675-2628
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
249072
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
249072
NY
207RP1001X
Pulmonary Disease Physician
Primary
249072
NY
Other
Enumeration date
11/28/2007
Last updated
10/22/2020
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