Provider Demographics
NPI:1386989846
Name:BEAUGE, PHILAINE (CNA)
Entity type:Individual
Prefix:
First Name:PHILAINE
Middle Name:
Last Name:BEAUGE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 MACON PL
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-2829
Mailing Address - Country:US
Mailing Address - Phone:516-279-5404
Mailing Address - Fax:
Practice Address - Street 1:574 MACON PL
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2829
Practice Address - Country:US
Practice Address - Phone:516-279-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343196341211E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide