Individual
ANTHONY JAMES BELLOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
475 E MAIN ST # 11772, PATCHOGUE, NY 11772-3121
(631) 363-2001
(631) 702-8049
Mailing address
1500 ROUTE 112 BLDG 4, SUITE101, PORT JEFFERSON STATION, NY 11776
(631) 751-3000
(631) 509-6559
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
100964
NY
Other
Enumeration date
09/22/2017
Last updated
07/30/2019
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