Healthcare Provider Details

I. General information

NPI: 1720069958
Provider Name (Legal Business Name): JOSEPH FRANK BENINCASA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 MEACHAM AVE
ELMONT NY
11003-2630
US

IV. Provider business mailing address

1147 RUSSELL ST
FRANKLIN SQUARE NY
11010-1519
US

V. Phone/Fax

Practice location:
  • Phone: 516-354-2950
  • Fax: 516-354-3375
Mailing address:
  • Phone: 516-437-7396
  • Fax: 516-354-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number024250
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: