Individual
DEYQUAN MALIK BELLAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
350 BLAKE AVE APT 5A, BROOKLYN, NY 11212-6346
(347) 512-6521
Mailing address
350 BLAKE AVE APT 5A, BROOKLYN, NY 11212-6346
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
033628
NY
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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