Basic Information
| Provider Information | |||||||||
| NPI: | 1811060841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEUOY | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 MERMAID AVE | ||||||||
| Address2: | |||||||||
| City: | WINTHROP | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021521122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178468760 | ||||||||
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| Practice Location | |||||||||
| Address1: | 750 WASHINGTON ST | ||||||||
| Address2: | BOX 266 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021111526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176365594 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1757 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.