Provider Demographics
NPI:1366559189
Name:BELLAMY, NEVA (DCP, NPP)
Entity type:Individual
Prefix:
First Name:NEVA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:DCP, NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792-0448
Mailing Address - Country:US
Mailing Address - Phone:631-566-4325
Mailing Address - Fax:
Practice Address - Street 1:29 RUSTIC RD
Practice Address - Street 2:
Practice Address - City:YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11980-9754
Practice Address - Country:US
Practice Address - Phone:631-566-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400955-1363LP0808X
106H00000X
NY453601163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health