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Individual
DR. LISETTE ANN BEAM
Active
Individual
DR. LISETTE ANN BEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC31054
CA
111N00000X
Chiropractor
X010427
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4544951
BCBS PROVIDER#
NY
01
—
562335358
TAX ID
NY
01
—
752842363
TAX ID
CA
01
—
C104275W
WORKERS COMPENSATION
NY
Enumeration date
05/08/2006
Last updated
12/07/2023
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