Provider Demographics
NPI:1235310566
Name:BECKLES, RUTH
Entity Type:Individual
Prefix:MISS
First Name:RUTH
Middle Name:
Last Name:BECKLES
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 1:51 E BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-2021
Mailing Address - Country:US
Mailing Address - Phone:631-569-2427
Mailing Address - Fax:631-254-1461
Practice Address - Street 1:51 E BELMONT ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-2021
Practice Address - Country:US
Practice Address - Phone:631-714-5619
Practice Address - Fax:631-254-1461
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02177562164W00000X
NY22 620273163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse