Provider Demographics
NPI:1811356660
Name:BEATTY, INGER CHARLENE (TEACHER)
Entity type:Individual
Prefix:MS
First Name:INGER
Middle Name:CHARLENE
Last Name:BEATTY
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 PARK PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4508
Mailing Address - Country:US
Mailing Address - Phone:347-512-2595
Mailing Address - Fax:718-483-8880
Practice Address - Street 1:1708 PARK PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-4508
Practice Address - Country:US
Practice Address - Phone:347-512-2595
Practice Address - Fax:718-483-8880
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor