Provider Demographics
NPI:1487928610
Name:BEAUJOUR, LOUIS R
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:R
Last Name:BEAUJOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CLEARVIEW DR
Mailing Address - Street 2:BRIDGEPORT, CT
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2447
Mailing Address - Country:US
Mailing Address - Phone:203-612-6156
Mailing Address - Fax:
Practice Address - Street 1:2233 NOSTRAND AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3029
Practice Address - Country:US
Practice Address - Phone:718-859-9760
Practice Address - Fax:718-859-9767
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health