Provider Demographics
NPI:1033345749
Name:BEAUBOEUF, RICHARD PHILIPPE (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PHILIPPE
Last Name:BEAUBOEUF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5409
Mailing Address - Country:US
Mailing Address - Phone:914-909-9218
Mailing Address - Fax:
Practice Address - Street 1:660 COLUMBUS AVENUE
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594-1909
Practice Address - Country:US
Practice Address - Phone:914-769-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist