Individual
SHANE THOMAS BEALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
61 EMERALD PL, ROCK HILL, NY 12775-6049
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4057
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
329923
NY
207Q00000X
Family Medicine Physician
OT019811
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
329923
NY
Other
Enumeration date
04/16/2020
Last updated
06/11/2024
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