Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 192719 | NY |
Y | 2080P0210X | Pediatric Nephrologist | 192719 | NY |
NPI | 1700853355 |
---|---|
Provider Name | Corinne Benchimol |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 24/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
192719 | LICENSE (01) | NY |