Individual
ALYSE R BELLOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
466 OLD HOOK ROAD, SUITE 1, EMERSON, NJ 07630-1368
(518) 272-0234
Mailing address
466 OLD HOOK ROAD, SUITE 1, EMERSON, NJ 07630-1368
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
183197-1
NY
207RG0100X
Gastroenterology Physician
Primary
25MA08394400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000405355001
BLUE SHIELD
NY
01
—
040426006461
FIDELIS
NY
01
—
100008772
RR/MCR
NY
01
—
10002444
CDPHP
NY
01
—
107014
MVP
NY
01
—
127303
WELLCARE
NY
01
—
1415851130011
CIGNA
NY
05
—
1638733
—
NY
01
—
2505278
GHI
NY
01
—
27303
GHI/HMO
NY
01
—
39J23
EMPIRE BC/BS
NY
01
—
5269090
AETNA
NY
Enumeration date
07/27/2006
Last updated
12/13/2012
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