Provider Demographics
NPI:1609971316
Name:BEIM, YAKOV (DPM)
Entity type:Individual
Prefix:DR
First Name:YAKOV
Middle Name:
Last Name:BEIM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13355 LEFFERTS BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3131
Mailing Address - Country:US
Mailing Address - Phone:347-921-3668
Mailing Address - Fax:718-738-3930
Practice Address - Street 1:13355 LEFFERTS BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420
Practice Address - Country:US
Practice Address - Phone:347-921-3668
Practice Address - Fax:718-738-3930
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005573213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02146610Medicaid
NY02146610Medicaid
NYU84878Medicare UPIN
NYPG3152Medicare ID - Type UnspecifiedEMPIRE MEDICARE