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NPI Code Detail

MEDICARE: NICHOLAS ALEXANDER BEAM

MEDICARE: NICHOLAS ALEXANDER BEAM
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
12084N0400XNeurology PhysicianSP019184PA
2207RH0003XHematology & Oncology PhysicianSP019184PA
3363LF0000XFamily Nurse PractitionerSP019184PA

General Provider Information

NPI Number : 1053881896
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS ALEXANDER BEAM
Provider Business Mailing Address
First Line : 3400 CIVIC CENTER BLVD
Second Line : 4TH FLOOR, WEST PAVILION
City : PHILADELPHIA
State : PA
Zip : 19104-5157
Country : US
Telephone Number : 215-615-5858
Fax Number :
Provider Business Practice Location Address
First Line : 3400 CIVIC CENTER BOULEVARD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-5127
Country : US
Telephone Number : 215-615-0063
Fax Number : 215-349-8144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2018
Last Update Date : 03/17/2026

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Directions to “ NICHOLAS ALEXANDER BEAM ” Practice Location

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