Provider Demographics
NPI:1730742461
Name:BENYOWITZ, ADINA (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ADINA
Middle Name:
Last Name:BENYOWITZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 CLARKS LN APT A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2519
Mailing Address - Country:US
Mailing Address - Phone:410-370-3711
Mailing Address - Fax:
Practice Address - Street 1:1711 LANDRAKE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-1822
Practice Address - Country:US
Practice Address - Phone:410-887-3568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07882225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist