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NPI Code Detail

MEDICARE: ESTELA A BEALE M.D.

MEDICARE: ESTELA A BEALE M.D.
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
12084P0800XPsychiatry Physician14142KS
22084P0800XPsychiatry Physician24141CO
32084P0800XPsychiatry Physician10531OK
42084P0800XPsychiatry PhysicianH7122TX
52084P0800XPsychiatry PhysicianMD448067PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386704971
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTELA A BEALE M.D.
Provider Business Mailing Address
First Line : 4900 WYALUSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-5127
Country : US
Telephone Number : 215-921-3713
Fax Number :
Provider Business Practice Location Address
First Line : 4900 WYALUSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-5127
Country : US
Telephone Number : 215-473-7033
Fax Number : 215-878-9199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 03/07/2019

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Directions to “ ESTELA A BEALE M.D.” Practice Location

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