Healthcare Provider Details

I. General information

NPI: 1063009751
Provider Name (Legal Business Name): DANA BEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E GATE BLVD
GARDEN CITY NY
11530-2105
US

IV. Provider business mailing address

23 SHOAL DR
WEST ISLIP NY
11795-5134
US

V. Phone/Fax

Practice location:
  • Phone: 516-745-8050
  • Fax: 516-745-6766
Mailing address:
  • Phone: 631-365-7789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number046638-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: