Provider Demographics
NPI:1760461602
Name:BEALE, EILEEN P (DO)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:P
Last Name:BEALE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:721 ARBOR WAY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1917
Mailing Address - Country:US
Mailing Address - Phone:215-646-9220
Mailing Address - Fax:215-646-0715
Practice Address - Street 1:721 ARBOR WAY
Practice Address - Street 2:SUITE 105
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1917
Practice Address - Country:US
Practice Address - Phone:215-646-9220
Practice Address - Fax:215-646-0715
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2016-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006004L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE52906Medicare UPIN
PA564099Medicare PIN