Basic Information
| Provider Information | |||||||||
| NPI: | 1306863329 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BELMONT AESTHETIC & RECONSTRUCTIVE PLASTIC SURGERY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5530 WISCONSIN AVENUE | ||||||||
| Address2: | SUITE 818 | ||||||||
| City: | CHEVY CHASE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016545666 | ||||||||
| FaxNumber: | 3016545552 | ||||||||
| Practice Location | |||||||||
| Address1: | 5530 WISCONSIN AVE | ||||||||
| Address2: | SUITE 818 | ||||||||
| City: | CHEVY CHASE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016545666 | ||||||||
| FaxNumber: | 3016575638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 06/19/2018 | ||||||||
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| AuthorizedOfficialLastName: | FELEDY | ||||||||
| AuthorizedOfficialFirstName: | JULES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3016545666 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.