Provider Demographics
NPI:1750557492
Name:KSENIJA BELSLEY, MD, PLLC
Entity type:Organization
Organization Name:KSENIJA BELSLEY, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KSENIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-879-8500
Mailing Address - Street 1:PO BOX 2759
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10116-2759
Mailing Address - Country:US
Mailing Address - Phone:212-879-8500
Mailing Address - Fax:
Practice Address - Street 1:245 5TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8728
Practice Address - Country:US
Practice Address - Phone:212-879-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223606208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty