Individual
CHANTALE D BEAUVAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 ANN ROSE ST, MASSAPEQUA, NY 11758
(516) 797-0496
Mailing address
13 ANN ROSE ST, MASSAPEQUA, NY 11758
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F335289-1
NY
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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