MEDICARE: DR. NADINE S BEACH DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X010939-1	NY

General Provider Information

NPI Number	:	1235208554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADINE S BEACH DC

Provider Business Mailing Address
First Line	:	21 E MADISON ST
Second Line	:
City	:	EAST ISLIP
State	:	NY
Zip	:	11730-1605
Country	:	US
Telephone Number	:	631-650-9113
Fax Number	:

Provider Business Practice Location Address
First Line	:	972 SUNRISE HWY
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-6110
Country	:	US
Telephone Number	:	631-422-6675
Fax Number	:	631-422-6718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. NADINE S BEACH DC” Practice Location

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