Phyllis Beck, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

256526-1 Issued in NY

Practice address

240 N Riley Ave
Mattituck, NY 11952-1859

Phone

(631) 438-2183

NPI assigned

Nov 10, 2016

Last updated

Nov 10, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1073055836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N RILEY AVE",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521859",
            "telephone_number": "631-438-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N RILEY AVE",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521859",
            "telephone_number": "631-438-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "PHYLLIS",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "256526-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Kim Bales, M.A., C.C.C., SLP
• Barkers Pharmacy Inc.
• Barths of Mattituck Inc (Barth's Pharmacy)
• Andrea Basile
• Nicole Marie Battaglia, LCSW
• Terry Becker
• Catherine Beecher
• Holly A Berdinka, MPT
• Alex Boukas, DDS
• Geraldine Anne Brodarick, RN

• Licensed Practical Nurse in Mattituck, NY
• Providers in Mattituck, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.