Provider Demographics
NPI:1124039060
Name:DEAN, BEVERLY ANN (NP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:DEAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:181 BELLEMEADE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3495
Mailing Address - Country:US
Mailing Address - Phone:631-444-5858
Mailing Address - Fax:631-444-1899
Practice Address - Street 1:181 N BELLE MEAD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3495
Practice Address - Country:US
Practice Address - Phone:631-444-5858
Practice Address - Fax:631-444-1899
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-07-24
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Provider Licenses
StateLicense IDTaxonomies
NY333649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY66176Medicare UPIN