MEDICARE: SAMILIA BECKLEY

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	163W00000X	Registered Nurse	618199	NY

General Provider Information

NPI Number	:	1730913203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMILIA BECKLEY

Provider Business Mailing Address
First Line	:	256 FARRAGUT RD
Second Line	:
City	:	NORTH PLAINFIELD
State	:	NJ
Zip	:	07062-2340
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	256 FARRAGUT RD
Second Line	:
City	:	NORTH PLAINFIELD
State	:	NJ
Zip	:	07062-2340
Country	:	US
Telephone Number	:	914-267-7307
Fax Number	:

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

Provider Enumeration Date	:	08/28/2024
Last Update Date	:	08/28/2024

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Directions to “ SAMILIA BECKLEY ” Practice Location

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