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General NPI Number Information
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NPI Number | 1093589970
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Entity Type | Individual
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Provider Name | MS. BEVERLY FLEMER
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Gender | Female
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 8330 118TH ST APT 4G
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City | KEW GARDENS
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State | NY
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Zip | 11415-2347
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Country | US
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Telephone | 134-764-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 83-30 118 STREET APARTMENT 4G
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City | KEW GARDENS
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State | NY
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Zip | 11415
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Country | US
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Telephone | 134-764-1742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1701015231
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License Number State | NY
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