Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 247266 | NY |
Y | 111NI0900X | Internist | 247266 | NY |
N | 207R00000X | Internist | ME105774 | FL |
N | 111NI0900X | Internist | ME105774 | FL |
N | 207RP1001X | Pulmonary Disease | 247266 | NY |
NPI | 1003081936 |
---|---|
Provider Name | Frederick C Beckett III |
First Address | West Chester, PA 19382-7142 |
Second Address | New Windsor, NY 12553-5557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 11/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03733617 | (05) | NY |
CQ937Z | (02) | FL |