Individual provider · NPI-1

Dr. Benita Benjamin, DO

Family Medicine · Glen Cove, NY

NPI number1366948499
StatusActive
Last updated in NPPESJul 6, 2021

Details

NPI
1366948499
Entity type
Individual (NPI-1)
Name
Dr. Benita Benjamin
Credential
DO
Sex
Female
Sole proprietor
No
Enumeration date
Apr 5, 2018
Certification date
Jul 6, 2021
Last updated
Jul 6, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine309326NYYes

Practice location

10 Medical Plz
Glen Cove, NY 11542-2101

Phone 516-679-0239

Mailing address

10 Medical Plz
Glen Cove, NY 11542-2101

Phone 516-676-0239

Other practice locations

888 Old Country Rd
Plainview, NY 11803-4914

Phone 516-661-7390

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