Provider Demographics
NPI:1598142572
Name:BEAUZILE, JAMES ANTOINE (RN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANTOINE
Last Name:BEAUZILE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E 161ST ST
Mailing Address - Street 2:APT. 9E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-6900
Mailing Address - Country:US
Mailing Address - Phone:212-427-6960
Mailing Address - Fax:
Practice Address - Street 1:501 EAST 161ST STREET
Practice Address - Street 2:APT. 9E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:347-262-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605293163WA0400X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health