| Doctor Name: | MR. JOHN A BEATTIE |
| NPI Number: | 1063510394 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 001222-1 |
| Business Practice Address: | 101 Hospital Rd Patchogue, NY - 117724870 |
| Business Phone Number: | 6316874179 |
| Business Fax Number: | |
| Mailing Address: | 8 Pinehurst Ct, SELDEN |
| State: | NY |
| Postal Code: | 117843223 |
| Phone Number: | 6316982678 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 001222-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |