National Provider Identifier
Ethan Nere Beaudett, D.O
Ethan Nere Beaudett, D.O is listed in the NPPES registry with a primary specialty of Sports Medicine (Family Medicine) Physician in Rochester, NY and a listed phone number of (585) 275-2662.
Profile Overview
- NPI
- 1205240835
- Provider Type
- Individual
- Primary Specialty
- Sports Medicine (Family Medicine) Physician
- Enumeration Date
- June 11, 2014
- Last Updated
- June 30, 2023
Practice Location
- 738 Library Road
- #1
- Rochester, NY 14627-0617
Phone: (585) 275-2662
Mailing Address
- 738 Library Road
- PO Box 270617
- Rochester, NY 14627-0617
Specialties
- Sports Medicine (Family Medicine) Physician (207QS0010X)
- Family Medicine Physician (207Q00000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Endpoints
- ebeaudett116771@direct.urmc.rochester.edu
Direct Messaging Address | Direct | Other | Rochester, NY 14642
Full Record
- NPI
- 1205240835
- Entity Type
- Individual
- Last Name
- Beaudett
- First Name
- Ethan
- Middle Name
- Nere
- Credential
- D.O
- Mailing Street Address
- 738 Library Road
- Mailing Address Line 2
- PO Box 270617
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14627-0617
- Mailing Country
- US
- Mailing Phone
- (585) 275-2662
- Mailing Fax
- (585) 276-0149
- Practice Street Address
- 738 Library Road
- Practice Address Line 2
- #1
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14627-0617
- Practice Country
- US
- Practice Phone
- (585) 275-2662
- Practice Fax
- (585) 276-0149
- Enumeration Date
- June 11, 2014
- Last Updated
- June 30, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- May 28, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Sports Medicine (Family Medicine) Physician (207QS0010X), Family Medicine Physician (207Q00000X), Student in an Organized Health Care Education/Training Program (390200000X)