MEDICARE: SASHAUNA BEALE RN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	407845	NY
2	164W00000X	Licensed Practical Nurse	309688	NY
3	163W00000X	Registered Nurse	692442	NY

General Provider Information

NPI Number	:	1528457686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SASHAUNA BEALE RN

Provider Business Mailing Address
First Line	:	712 BEACH 20TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	712 BEACH 20TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3502
Country	:	US
Telephone Number	:	718-471-0200
Fax Number	:

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

Provider Enumeration Date	:	01/13/2015
Last Update Date	:	03/12/2026

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