Provider Demographics
NPI:1528136413
Name:BEEBER, STUART EDWARD (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:EDWARD
Last Name:BEEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 KING ST
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3471
Mailing Address - Country:US
Mailing Address - Phone:914-493-7585
Mailing Address - Fax:914-594-4336
Practice Address - Street 1:175 KING ST
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3471
Practice Address - Country:US
Practice Address - Phone:914-493-7585
Practice Address - Fax:914-594-4336
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103642208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B17707Medicare UPIN