MEDICARE: THERESA MARIE BESHARA ACNP-CS

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	363LA2100X	Acute Care Nurse Practitioner	F331728	NY

General Provider Information

NPI Number	:	1093712366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA MARIE BESHARA ACNP-CS

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:	518-525-5634
Fax Number	:	518-649-4094

Provider Business Practice Location Address
First Line	:	63 SHAKER RD STE 201
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12204-1030
Country	:	US
Telephone Number	:	518-471-3636
Fax Number	:	518-471-3668

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	11/21/2025

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