Healthcare Provider Details

I. General information

NPI: 1336624964
Provider Name (Legal Business Name): CLAUDIA BEAUVAIS DNP MSN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAUDIA MARSEILLE DNP MSN FNP-BC

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 N MAIN ST
NEW SQUARE NY
10977-8916
US

IV. Provider business mailing address

30 FREDRICK DR
MONROE NY
10950-3002
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-9300
  • Fax:
Mailing address:
  • Phone: 845-616-7391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343644
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: