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NPI Code Detail

MEDICARE: CORINNE BEYER PHYSICIAN ASSISTANT

MEDICARE:   CORINNE  BEYER  PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant022211NY

General Provider Information

NPI Number : 1184102246
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORINNE BEYER PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 240 GRAND BLVD
Second Line :
City : MASSAPEQUA PARK
State : NY
Zip : 11762-2140
Country : US
Telephone Number : 516-659-4269
Fax Number :
Provider Business Practice Location Address
First Line : 240 GRAND BLVD
Second Line :
City : MASSAPEQUA PARK
State : NY
Zip : 11762-2140
Country : US
Telephone Number : 516-659-4269
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2018
Last Update Date : 01/10/2024

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Directions to “ CORINNE BEYER PHYSICIAN ASSISTANT” Practice Location

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