Provider Demographics
NPI:1023421625
Name:BELFIELD, BEATA (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:BEATA
Middle Name:
Last Name:BELFIELD
Suffix:
Gender:F
Credentials:MB BCH BAO
Other - Prefix:DR
Other - First Name:BEATA
Other - Middle Name:
Other - Last Name:LOBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MB BCH BAO
Mailing Address - Street 1:4100 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066-1956
Mailing Address - Country:US
Mailing Address - Phone:315-744-1551
Mailing Address - Fax:
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1899
Practice Address - Country:US
Practice Address - Phone:315-448-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT62524208600000X
NY305932208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery