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NPI Code Detail

MEDICARE: MR. MARIO BEAUGE RN

MEDICARE:  MR. MARIO  BEAUGE  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse489432-1NY

General Provider Information

NPI Number : 1013136761
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARIO BEAUGE RN
Provider Business Mailing Address
First Line : 420 NORTH AVE
Second Line :
City : NEW ROCHELLE
State : NY
Zip : 10801-4160
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 420 NORTH AVE
Second Line :
City : NEW ROCHELLE
State : NY
Zip : 10801-4160
Country : US
Telephone Number : 800-662-1704
Fax Number : 888-651-0971
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 11/23/2011

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Directions to “ MR. MARIO BEAUGE RN” Practice Location

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