1568770238 NPI number — MS. JOAN BECHT RN,ANP-BC,CPNP

Table of content: MS. JOAN BECHT RN,ANP-BC,CPNP (NPI 1568770238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568770238 NPI number — MS. JOAN BECHT RN,ANP-BC,CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BECHT
Provider First Name:
JOAN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN,ANP-BC,CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568770238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
496 COUNTY ROAD 111
Provider Second Line Business Mailing Address:
BUILDING B
Provider Business Mailing Address City Name:
MANORVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11949-2583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-405-3200
Provider Business Mailing Address Fax Number:
631-395-6010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
185 OLD COUNTRY RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
RIVERHEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11901-2121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-298-4479
Provider Business Practice Location Address Fax Number:
631-591-3047
Provider Enumeration Date:
09/16/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  463448 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 302323 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP0200X , with the licence number: 382127 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)