Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 084528 | NY |
NPI | 1184959710 |
---|---|
Provider Name | Carl Myron Beiles |
First Address | Brookville, NY 11545-3125 |
Second Address | Glen Head, NY 11545-3125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2009 |
Last Update Date | 15/10/2009 |