Provider Demographics
NPI:1538904156
Name:BHEALTHYRN LLC
Entity type:Organization
Organization Name:BHEALTHYRN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BEVIN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:AGACNP
Authorized Official - Phone:718-450-0172
Mailing Address - Street 1:31 TIOGA STREET
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4352
Mailing Address - Country:US
Mailing Address - Phone:718-450-0172
Mailing Address - Fax:
Practice Address - Street 1:31 TIOGA STREET
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4352
Practice Address - Country:US
Practice Address - Phone:718-450-0172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care