MEDICARE: BEACH CHIROPRACTIC WELLNESS PLLC

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	225700000X	Massage Therapist
2	111NR0400X	Rehabilitation Chiropractor

General Provider Information

NPI Number	:	1669306429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACH CHIROPRACTIC WELLNESS PLLC

Provider Business Mailing Address
First Line	:	972 SUNRISE HWY
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-6110
Country	:	US
Telephone Number	:	631-422-6675
Fax Number	:	631-422-6718

Provider Business Practice Location Address
First Line	:	972 SUNRISE HWY
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-6110
Country	:	US
Telephone Number	:	631-422-6675
Fax Number	:	631-422-6718

Authorized Official
Title or Position	:	OWNER
Name	:	NADINE S BEACH
Credential	:	DC
Telephone Number	:	631-422-6675

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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