Provider Demographics
NPI:1104048677
Name:BEAUGARD & SCHEUCH MD PA
Entity type:Organization
Organization Name:BEAUGARD & SCHEUCH MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:SCHEUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-836-6060
Mailing Address - Street 1:870 PALISADE AVENUE
Mailing Address - Street 2:SUITE 201 A
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-836-6060
Mailing Address - Fax:201-836-8401
Practice Address - Street 1:20 PROSPECT AVENUE
Practice Address - Street 2:SUITE 717
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-343-9010
Practice Address - Fax:201-343-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA42382174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1144283235OtherINDIVIDUAL NPI
NJ541455Medicare ID - Type UnspecifiedJOHN R. SCHEUCH MD
NJ1144283235OtherINDIVIDUAL NPI