Provider Demographics
NPI:1992894968
Name:BEURY, JEFFREY (CH)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:BEURY
Suffix:
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12037-1110
Mailing Address - Country:US
Mailing Address - Phone:518-392-2300
Mailing Address - Fax:518-392-8581
Practice Address - Street 1:19 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12037-1110
Practice Address - Country:US
Practice Address - Phone:518-392-2300
Practice Address - Fax:518-392-8581
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX16K41Medicare PIN