Beard, Charles Theodore

Beard, Charles Theodore is an individual health care provider with primary practice located at 1456 Fulton St Bedford Stuyvesant Family Health Center, Brooklyn NY 11216-2505. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Beard, Charles Theodore can be contacted via phone (718) 636-4500.

Contact Information

Primary practice address
1456 Fulton St Bedford Stuyvesant Family Health Center Brooklyn NY 11216-2505
Phone: (718) 636-4500
Fax: (347) 296-8363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 043006 New York

Profile Details

NPI number 1558338087
LBN Legal business name Beard, Charles Theodore
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2006
Last updated May 4th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558338087 NPPES
New York MEDICAID 01485652

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