Basic Information
| Provider Information | |||||||||
| NPI: | 1760832729 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECKMAN | ||||||||
| FirstName: | ALICE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 256 SEAMAN AVE APT 4A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100341200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853174102 | ||||||||
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| Practice Location | |||||||||
| Address1: | 610 W 158TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100327104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125441881 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2016 | ||||||||
| LastUpdateDate: | 02/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 300339 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.