Provider Demographics
NPI:1134340490
Name:CHAPPAQUA PEDIATRICS
Entity type:Organization
Organization Name:CHAPPAQUA PEDIATRICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BEEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-238-8550
Mailing Address - Street 1:175 KING ST
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514
Mailing Address - Country:US
Mailing Address - Phone:914-238-8550
Mailing Address - Fax:914-238-8838
Practice Address - Street 1:175 KING ST
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514
Practice Address - Country:US
Practice Address - Phone:914-238-8550
Practice Address - Fax:914-238-8838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103642208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty