Provider Demographics
NPI:1700448867
Name:BENJAMIN, DEVIN E
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:E
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 21ST ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4733
Mailing Address - Country:US
Mailing Address - Phone:917-444-0814
Mailing Address - Fax:
Practice Address - Street 1:3421 21ST ST APT 6E
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-4733
Practice Address - Country:US
Practice Address - Phone:917-444-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator