Provider Demographics
NPI:1548431307
Name:SURMA, BEATA (MD)
Entity Type:Individual
Prefix:
First Name:BEATA
Middle Name:
Last Name:SURMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:972 BRUSH HOLLOW RD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1740
Mailing Address - Country:US
Mailing Address - Phone:516-876-5555
Mailing Address - Fax:516-876-5539
Practice Address - Street 1:1 SCHOOL ST
Practice Address - Street 2:SUITE 203
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2545
Practice Address - Country:US
Practice Address - Phone:516-671-9800
Practice Address - Fax:516-671-9283
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08376500207Q00000X
NY249401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine