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General NPI Number Information
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NPI Number | 1083968408
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Entity Type | Organization
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Legal Business Name | NADINE S. BEACH DC, PC
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Dates
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Enumeration Date | 11/07/2012
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 972 SUNRISE HWY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6110
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Country | US
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Telephone | 631-422-6675
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Fax | 631-422-6718
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Provider Business Mailing Address
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Address Line | 972 SUNRISE HWY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6110
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | NADINE BEACH
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Credential |
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Telephone | 631-422-6675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010939-1
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License Number State | NY
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