Provider Demographics
NPI:1528597416
Name:OOMMEN, BEENA GEEVARUGHESE
Entity Type:Individual
Prefix:
First Name:BEENA
Middle Name:GEEVARUGHESE
Last Name:OOMMEN
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 1:338 LONGVUE TER
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2113
Mailing Address - Country:US
Mailing Address - Phone:914-457-0462
Mailing Address - Fax:
Practice Address - Street 1:338 LONGVUE TER
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2113
Practice Address - Country:US
Practice Address - Phone:914-457-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605686-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse