Healthcare Provider Details

I. General information

NPI: 1295718856
Provider Name (Legal Business Name): CLARE A BEAGEN-MCHUGH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 TARGEE ST HEALTHCARE ASSOCIATES IN MEDICINE
STATEN ISLAND NY
10304-4310
US

IV. Provider business mailing address

1099 TARGEE ST HEALTHCARE ASSOCIATES IN MEDICINE
STATEN ISLAND NY
10304-4310
US

V. Phone/Fax

Practice location:
  • Phone: 718-448-3210
  • Fax: 718-720-1271
Mailing address:
  • Phone: 718-448-3210
  • Fax: 718-720-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0059731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: