Provider Demographics
NPI:1265520878
Name:BELMONT, MARY FERGUSON (EDD, NP)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:FERGUSON
Last Name:BELMONT
Suffix:
Gender:F
Credentials:EDD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E 72ND ST
Mailing Address - Street 2:APARTMENT 3D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4849
Mailing Address - Country:US
Mailing Address - Phone:212-737-3886
Mailing Address - Fax:
Practice Address - Street 1:520 E 72ND ST
Practice Address - Street 2:APARTMENT 3D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4849
Practice Address - Country:US
Practice Address - Phone:212-737-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247781163WA2000X, 163WG0600X
NY340273363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WG0600XNursing Service ProvidersRegistered NurseGerontology