Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 64845 | CT |
Y | 207RC0000X | Internist - Cardiovascular Disease | 64845 | CT |
NPI | 1063855708 |
---|---|
Provider Name | Dr. Michael Harry Beasley |
First Address | New Haven, CT 06520-8017 |
Second Address | New Haven, CT 06510-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 06/01/2022 |