Provider Demographics
NPI:1396978920
Name:BEEBE, STEPHEN R (RPSGT, BA, MLT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:R
Last Name:BEEBE
Suffix:
Gender:M
Credentials:RPSGT, BA, MLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3440
Mailing Address - Country:US
Mailing Address - Phone:716-636-0347
Mailing Address - Fax:716-636-0347
Practice Address - Street 1:1164 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3440
Practice Address - Country:US
Practice Address - Phone:716-636-0347
Practice Address - Fax:716-636-0347
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG