Provider Demographics
NPI:1609023001
Name:JAMES, BEVERLY R
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:R
Last Name:JAMES
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 1:1400 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5156
Mailing Address - Country:US
Mailing Address - Phone:516-794-0700
Mailing Address - Fax:
Practice Address - Street 1:1400 OLD COUNTRY RD
Practice Address - Street 2:SUITE 108
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5156
Practice Address - Country:US
Practice Address - Phone:516-794-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2052321163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator