Provider Demographics
NPI:1043990906
Name:BEECHER, AUDREY (PTA)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:BEECHER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 N PLANK RD STE 10
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2111
Mailing Address - Country:US
Mailing Address - Phone:914-374-3630
Mailing Address - Fax:
Practice Address - Street 1:17 N PLANK RD STE 10
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2111
Practice Address - Country:US
Practice Address - Phone:914-374-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty