MEDICARE: BEVERLY PERRONE

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
1	302R00000X	Health Maintenance Organization	635359	NY
2	163W00000X	Registered Nurse	635359-01	NY

General Provider Information

NPI Number	:	1093173262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY PERRONE

Provider Business Mailing Address
First Line	:	73 BARDOLIER LN
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-7643
Country	:	US
Telephone Number	:	347-277-6409
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 BARDOLIER LN
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-7643
Country	:	US
Telephone Number	:	347-277-6409
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2016
Last Update Date	:	01/23/2026

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Directions to “ BEVERLY PERRONE ” Practice Location

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