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General NPI Number Information
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NPI Number | 1992471189
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Entity Type | Organization
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Legal Business Name | BECKLES PRIMARY CARE PLLC
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 40 W 135TH ST APT 1B
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City | NEW YORK
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State | NY
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Zip | 10037-2530
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Country | US
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Telephone | 212-283-5118
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Fax |
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Provider Business Mailing Address
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Address Line | 344 E 51ST ST APT 3F
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City | BROOKLYN
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State | NY
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Zip | 11203-3522
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Country | US
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Telephone | 347-967-8448
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JANINE BECKLES
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Credential | MD
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Telephone | 347-967-8448
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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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