Provider Demographics
NPI:1699009720
Name:EXAMOND, BEATRICE
Entity Type:Individual
Prefix:MS
First Name:BEATRICE
Middle Name:
Last Name:EXAMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BEATRICE
Other - Middle Name:
Other - Last Name:LABISSIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1632 KENNETH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-603-0577
Mailing Address - Fax:
Practice Address - Street 1:1401 LANGDON BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3517
Practice Address - Country:US
Practice Address - Phone:516-603-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308305363LA2200X
NY620020163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health