Provider Demographics
NPI:1144697632
Name:BEGLEY, MARY JANE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MARY JANE
Middle Name:
Last Name:BEGLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 OSWEGO RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-5022
Mailing Address - Country:US
Mailing Address - Phone:845-677-8085
Mailing Address - Fax:
Practice Address - Street 1:144 TODD HILL RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5916
Practice Address - Country:US
Practice Address - Phone:845-486-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337856-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse