Provider Demographics
NPI:1093864910
Name:BEAUDOIN, MARGARET CHERNACK (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:CHERNACK
Last Name:BEAUDOIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1215
Mailing Address - Country:US
Mailing Address - Phone:516-766-6674
Mailing Address - Fax:516-766-6674
Practice Address - Street 1:88 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1215
Practice Address - Country:US
Practice Address - Phone:516-766-6674
Practice Address - Fax:516-766-6674
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008869103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical