Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 040990 | CT |
NPI | 1285921395 |
---|---|
Provider Name | Dr. Chan Rodney Beals |
First Address | Westfield, NJ 07090-2445 |
Second Address | Westfield, NJ 07090-2445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2011 |
Last Update Date | 10/07/2011 |