Provider Demographics
NPI:1972555019
Name:BECKMAN, HOWARD BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:BRUCE
Last Name:BECKMAN
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 1:285 WESTMINSTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3229
Mailing Address - Country:US
Mailing Address - Phone:585-341-6775
Mailing Address - Fax:585-341-0861
Practice Address - Street 1:990 SOUTH AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2740
Practice Address - Country:US
Practice Address - Phone:585-341-6775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000915209001OtherHEALTH NOW
NYMD182MOtherPREFERRED CARE MVP
NY010182175OtherBLUE CHOICE
NY01230946Medicaid
NYD72617Medicare UPIN
NY01230946Medicaid