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Individual
NATHANIAL J BEACH
Active
Individual
NATHANIAL J BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
020418
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02203189
—
NY
01
—
11225325
CAQH
NY
Enumeration date
01/10/2007
Last updated
09/20/2007
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