Healthcare Provider Details

I. General information

NPI: 1881189660
Provider Name (Legal Business Name): DAPHNEE BEAULIEU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 FRANKLIN AVE
GARDEN CITY NY
11530-1617
US

IV. Provider business mailing address

1111 FRANKLIN AVE
GARDEN CITY NY
11530-1617
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-1145
  • Fax: 929-455-9927
Mailing address:
  • Phone: 516-663-1145
  • Fax: 929-455-9927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number326972
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: