MEDICARE: DR. HENRY GRAFTON BEECHER 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
1	207RG0100X	Gastroenterology Physician	045166	CT
2	207RG0100X	Gastroenterology Physician	225212	NY

General Provider Information

NPI Number	:	1396949582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY GRAFTON BEECHER M.D.

Provider Business Mailing Address
First Line	:	3725 BLACKSTONE AVE
Second Line	:	APARTMENT 4C
City	:	BRONX
State	:	NY
Zip	:	10463-1443
Country	:	US
Telephone Number	:	718-432-6424
Fax Number	:	718-432-6424

Provider Business Practice Location Address
First Line	:	32 STRAWBERRY HILL CT
Second Line	:	SUITE 41042
City	:	STAMFORD
State	:	CT
Zip	:	06902-2594
Country	:	US
Telephone Number	:	203-348-5355
Fax Number	:	203-348-4082

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/08/2007

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