Provider Demographics
NPI:1346382637
Name:BEAM, ROBERT HAROLD JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HAROLD
Last Name:BEAM
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CANDLEWOOD CMNS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2173
Mailing Address - Country:US
Mailing Address - Phone:732-901-3001
Mailing Address - Fax:732-901-3105
Practice Address - Street 1:602 CANDLEWOOD CMNS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2173
Practice Address - Country:US
Practice Address - Phone:732-901-3001
Practice Address - Fax:732-901-3105
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00451400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ781867OtherMEDICARE PTAN
U59279Medicare UPIN
NJ6540201Medicaid