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General NPI Number Information
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NPI Number | 1629011671
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Entity Type | Organization
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Legal Business Name | BEAMS & GILSENAN D.O., PC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 67 WALNUT AVE SUITE 202
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City | CLARK
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State | NJ
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Zip | 07066-1640
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Country | US
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Telephone | 732-388-7300
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Fax | 732-388-1330
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Provider Business Mailing Address
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Address Line | 67 WALNUT AVE SUITE 202
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City | CLARK
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State | NJ
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Zip | 07066-1640
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Country | US
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Telephone | 732-388-7300
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Fax | 732-388-1330
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | MICHAEL ELLIOT BEAMS
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Credential | D.O.
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Telephone | 732-388-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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