Basic Information
Provider Information
NPI: 1972763795
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEURIA
FirstName: PRARTHANA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 GUSTAVE L.LEVY PLACE
Address2: BOX 3000
City: NEW YORK
State: NY
PostalCode: 10029
CountryCode: US
TelephoneNumber: 2129873100
FaxNumber: 2127315210
Practice Location
Address1: 234 E 85TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100283001
CountryCode: US
TelephoneNumber: 2122416585
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/16/2008
LastUpdateDate: 02/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X250934NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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