Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | X008908 | NY |
NPI | 1215152947 |
---|---|
Provider Name | Dr. Carl A. Benjamin |
First Address | Cortlandt Manor, NY 10567-5906 |
Second Address | Peekskill, NY 10566-3814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |