Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glenn Stephen Beauchamp

Individual provider Registered Nurse · NPI 1124534219

Glenn Stephen Beauchamp is a Registered Nurse in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2017

Practice location Address checks out

245 Mill Rd Apt 3A
Staten Island, NY 10306-4747
Phone: (718) 979-6900
Fax: (718) 979-6940
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 604168-1 (NY)

Record details

NPI number1124534219
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 27, 2017
Last updated in NPPESDecember 27, 2017

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