Healthcare Provider Details

I. General information

NPI: 1497271472
Provider Name (Legal Business Name): NATACHA BEAUVAIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 11/17/2023
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W 59TH ST
NEW YORK NY
10019-8022
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL # 1118
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-5900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF349101
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number736862
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: