Healthcare Provider Details

I. General information

NPI: 1598524944
Provider Name (Legal Business Name): CORINNE BEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 MCDONALD AVE
BROOKLYN NY
11230-2647
US

IV. Provider business mailing address

1950 E 24TH ST
BROOKLYN NY
11229-2420
US

V. Phone/Fax

Practice location:
  • Phone: 718-252-5770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1064854
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: