Individual
MR. MARK TERRENCE BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1467 BEDFORD AVE, BROOKLYN, NY 11216-3851
(718) 550-2618
Mailing address
1538 NEW YORK AVE APT 2F, BROOKLYN, NY 11210-2770
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012562-01
NY
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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