Healthcare Provider Details

I. General information

NPI: 1942370044
Provider Name (Legal Business Name): JUDITH LYNN BEIZER PHARMD, CGP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11008 70TH RD
FOREST HILLS NY
11375-3934
US

IV. Provider business mailing address

11008 70TH RD
FOREST HILLS NY
11375-3934
US

V. Phone/Fax

Practice location:
  • Phone: 718-990-2489
  • Fax: 718-990-1986
Mailing address:
  • Phone: 718-990-2489
  • Fax: 718-990-1986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number036361-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: