Basic Information
| Provider Information | |||||||||
| NPI: | 1275533119 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELLOTTE | ||||||||
| FirstName: | JONATHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 STATE ST FL 4 | ||||||||
| Address2: | 4TH FLOOR, SUITE 401 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071427 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 300 STATE ST FL 4 | ||||||||
| Address2: | 4TH FLOOR, SUITE 401 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148775330 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2005 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MD417365 | PA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.