Provider Demographics
NPI:1023244837
Name:BEAUVIL, MAGDALA DOMINIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDALA
Middle Name:DOMINIQUE
Last Name:BEAUVIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:55 WATER STREET 2ND FLOOR CRED DEPT
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:200 OLD COUNTRY RD STE 141
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4235
Practice Address - Country:US
Practice Address - Phone:516-855-0046
Practice Address - Fax:516-855-0058
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY246625207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty