Individual
MARY ANN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
305 LOCUST AVE, OAKDALE, NY 11769-1652
(631) 218-5951
Mailing address
16 OAK ST, LAKE GROVE, NY 11755-2930
(631) 467-0769
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005949-1
NY
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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