Provider Demographics
NPI:1770618803
Name:SCLAR, BEVERLEE (CNS)
Entity type:Individual
Prefix:MS
First Name:BEVERLEE
Middle Name:
Last Name:SCLAR
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CONRY CRESCENT
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-524-7312
Mailing Address - Fax:
Practice Address - Street 1:8 ALTON PLACE SUITE #5
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-232-3822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA87271364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA364669OtherMAGELLAN
MAPN0204OtherBL CROSS BL SHIELD
MAPN0204OtherBL CROSS BL SHIELD
SCN50528Medicare ID - Type Unspecified