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General NPI Number Information
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NPI Number | 1972870541
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Entity Type | Individual
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Provider Name | JELANI BEYAH
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Gender | Male
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Dates
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Enumeration Date | 11/25/2011
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Last Update Date | 11/25/2011
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Provider Practice Location Address
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Address Line | 527 W 152ND ST APT 1B
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City | NEW YORK
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State | NY
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Zip | 10031-1604
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Country | US
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Telephone | 917-723-9725
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Fax |
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Provider Business Mailing Address
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Address Line | 527 W 152ND ST APT 1B
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City | NEW YORK
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State | NY
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Zip | 10031-1604
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Country | US
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Telephone | 917-723-9725
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | B000438884450
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License Number State | FL
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