Provider Demographics
NPI:1902551138
Name:BENJAMIN, GINA (CPR, FIRST AID CERT)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:CPR, FIRST AID CERT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5213
Mailing Address - Country:US
Mailing Address - Phone:202-341-8071
Mailing Address - Fax:
Practice Address - Street 1:501 E ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5213
Practice Address - Country:US
Practice Address - Phone:202-341-8071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant