Healthcare Provider Details

I. General information

NPI: 1538589890
Provider Name (Legal Business Name): TZURIEL BEN BINYAMIN LCAT, ATR-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date: 10/05/2015
Reactivation Date: 12/20/2018

III. Provider practice location address

505 8TH AVE # 12A
NEW YORK NY
10018-6505
US

IV. Provider business mailing address

75 S BROADWAY STE 1024
WHITE PLAINS NY
10601-4413
US

V. Phone/Fax

Practice location:
  • Phone: 917-274-7868
  • Fax:
Mailing address:
  • Phone: 917-274-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number002297
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: