Provider Demographics
NPI:1285735589
Name:BEAUGE, GARLINE (LPN)
Entity type:Individual
Prefix:MRS
First Name:GARLINE
Middle Name:
Last Name:BEAUGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:GARLINE
Other - Middle Name:
Other - Last Name:DIEUDONNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:480 N LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2637
Mailing Address - Country:US
Mailing Address - Phone:516-608-5404
Mailing Address - Fax:516-608-5404
Practice Address - Street 1:480 N LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2637
Practice Address - Country:US
Practice Address - Phone:516-608-5404
Practice Address - Fax:516-608-5404
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282427-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse