Provider Demographics
NPI:1871980409
Name:BEATON, VERA CATHERINE
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:CATHERINE
Last Name:BEATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4193 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NY
Mailing Address - Zip Code:13402-1507
Mailing Address - Country:US
Mailing Address - Phone:315-893-9996
Mailing Address - Fax:
Practice Address - Street 1:8855 CENTER POINTE DR
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-1421
Practice Address - Country:US
Practice Address - Phone:315-766-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY490244-1163W00000X, 163WA0400X, 163WA2000X, 163WC0400X, 163WM0705X, 163WP0807X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult