Provider Demographics
NPI:1134916992
Name:BENJAMIN, ZYASIA ALEXIS
Entity type:Individual
Prefix:
First Name:ZYASIA
Middle Name:ALEXIS
Last Name:BENJAMIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 N CALHOUN ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-2512
Mailing Address - Country:US
Mailing Address - Phone:144-340-1340
Mailing Address - Fax:
Practice Address - Street 1:617 N CALHOUN ST APT 5
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-2512
Practice Address - Country:US
Practice Address - Phone:144-340-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00221357376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide