Provider Demographics
NPI:1518382605
Name:NANCY BECKER
Entity Type:Organization
Organization Name:NANCY BECKER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, JPHN
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-786-6736
Mailing Address - Street 1:4559 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3330
Mailing Address - Country:US
Mailing Address - Phone:718-353-8078
Mailing Address - Fax:
Practice Address - Street 1:4809 CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11109-5605
Practice Address - Country:US
Practice Address - Phone:718-786-6736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262692-1251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare