Provider Demographics
NPI:1245637008
Name:PAPPAS, BETH ANN (NP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:BRUET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTIONER
Mailing Address - Street 1:115 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2049
Mailing Address - Country:US
Mailing Address - Phone:212-535-3505
Mailing Address - Fax:212-535-3568
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2049
Practice Address - Country:US
Practice Address - Phone:212-535-3505
Practice Address - Fax:212-535-3568
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$Medicare UPIN