Provider Demographics
NPI:1740457258
Name:WHITAKER, BEATRICE ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:ROSE
Last Name:WHITAKER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1111 AMSTERDAM AVE
Mailing Address - Street 2:DEPARTMENT OF OPHTHALMOLOGY, CLARK 2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:718-909-7817
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:DEPARTMENT OF OPHTHALMOLOGY, CLARK 2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:718-909-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY257688207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology