Provider Demographics
NPI:1700202504
Name:MCBEAN-BAILEY, ANDREA BEVERLY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:BEVERLY
Last Name:MCBEAN-BAILEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 NEW ENGLAND THRUWAY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3141
Mailing Address - Country:US
Mailing Address - Phone:917-754-0540
Mailing Address - Fax:347-964-6939
Practice Address - Street 1:3133 NEW ENGLAND THRUWAY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3141
Practice Address - Country:US
Practice Address - Phone:917-754-0540
Practice Address - Fax:347-964-6939
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277093-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse