Provider Demographics
NPI:1639430341
Name:MCNULTY, BEATRIZ (RN, WMS)
Entity Type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:
Last Name:MCNULTY
Suffix:
Gender:F
Credentials:RN, WMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 CEDARLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-4532
Mailing Address - Country:US
Mailing Address - Phone:518-669-4800
Mailing Address - Fax:
Practice Address - Street 1:2038 CEDARLAWN AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12306-4532
Practice Address - Country:US
Practice Address - Phone:518-669-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY626258-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse