Provider Demographics
NPI:1194178947
Name:SCHOEN, BETH TAMI
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:TAMI
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-0489
Mailing Address - Country:US
Mailing Address - Phone:845-827-6364
Mailing Address - Fax:845-827-5496
Practice Address - Street 1:375 ROUTE 32
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917
Practice Address - Country:US
Practice Address - Phone:845-827-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239905031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist