Provider Demographics
NPI:1306880752
Name:HAROLD E BEAM
Entity type:Organization
Organization Name:HAROLD E BEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-659-9990
Mailing Address - Street 1:300 HEBRON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2176
Mailing Address - Country:US
Mailing Address - Phone:860-659-9990
Mailing Address - Fax:860-659-4873
Practice Address - Street 1:300 HEBRON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2176
Practice Address - Country:US
Practice Address - Phone:860-659-9990
Practice Address - Fax:860-659-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029922208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty