Provider Demographics
NPI:1437727492
Name:BRUTUS, BEATRICE
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:BRUTUS
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 1:30 NORMANDY VLG UNIT 6
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2836
Mailing Address - Country:US
Mailing Address - Phone:845-548-6736
Mailing Address - Fax:
Practice Address - Street 1:30 NORMANDY VLG UNIT 6
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2836
Practice Address - Country:US
Practice Address - Phone:845-548-6736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010683224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant