Healthcare Provider Details

I. General information

NPI: 1104747161
Provider Name (Legal Business Name): TRICIA OLA BEN-DAVIES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 BEDFORD AVE
BROOKLYN NY
11226-5403
US

IV. Provider business mailing address

1838 E 32ND ST
BROOKLYN NY
11234-4444
US

V. Phone/Fax

Practice location:
  • Phone: 844-400-1975
  • Fax:
Mailing address:
  • Phone: 917-549-5386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132554
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: