Provider Demographics
NPI:1669734745
Name:BEATTIE, ALISON
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:BEATTIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:464 ROUTE 17A
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1014
Mailing Address - Country:US
Mailing Address - Phone:845-651-2251
Mailing Address - Fax:
Practice Address - Street 1:464 ROUTE 17A
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1014
Practice Address - Country:US
Practice Address - Phone:845-651-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204446021174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist