Provider Demographics
NPI:1952574436
Name:BEERS, CHRISTINE M (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:BEERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 MERRITTS RD STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3246
Mailing Address - Country:US
Mailing Address - Phone:516-420-9595
Mailing Address - Fax:
Practice Address - Street 1:199 MERRITTS RD STE C
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3246
Practice Address - Country:US
Practice Address - Phone:516-420-9595
Practice Address - Fax:516-420-1090
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004528OtherLICENSE