Provider Demographics
NPI:1184819377
Name:BEATTIE, HILARY JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:JANE
Last Name:BEATTIE
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 1:15 E 10TH ST # A
Mailing Address - Street 2:#1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5930
Mailing Address - Country:US
Mailing Address - Phone:212-673-8016
Mailing Address - Fax:
Practice Address - Street 1:15 E 10TH ST # A
Practice Address - Street 2:#1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5930
Practice Address - Country:US
Practice Address - Phone:212-673-8016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008356-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV44192Medicare PIN