Provider Demographics
NPI:1881772762
Name:BEEK, GRACE L (FNP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:L
Last Name:BEEK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 E 85TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5130
Mailing Address - Country:US
Mailing Address - Phone:718-968-8684
Mailing Address - Fax:
Practice Address - Street 1:754 E 151ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-3267
Practice Address - Country:US
Practice Address - Phone:718-401-5433
Practice Address - Fax:718-993-4395
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333980-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine