Provider Demographics
NPI:1902071855
Name:DUNEVITZ, BENJAMIN S (DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:S
Last Name:DUNEVITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 HUGUENOT ST
Mailing Address - Street 2:2416
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6387
Mailing Address - Country:US
Mailing Address - Phone:716-984-2832
Mailing Address - Fax:
Practice Address - Street 1:1311 MAMARONECK AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-5221
Practice Address - Country:US
Practice Address - Phone:914-681-8800
Practice Address - Fax:914-681-8899
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor