Basic Information
| Provider Information | |||||||||
| NPI: | 1477850147 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEER & BEER MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 SAGE EST | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122042237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183393755 | ||||||||
| FaxNumber: | 5184631589 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 TROY SCHENECTADY RD | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121102442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187869131 | ||||||||
| FaxNumber: | 5186900658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2011 | ||||||||
| LastUpdateDate: | 09/04/2013 | ||||||||
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| AuthorizedOfficialLastName: | BEER | ||||||||
| AuthorizedOfficialFirstName: | YORAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5183393755 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2088P0231X | 136071 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology |
ID Information
| ID | Type | State | Issuer | Description | 340011809 | 01 | NY | MEDICARE RAILROAD | OTHER |