Healthcare Provider Details

I. General information

NPI: 1447194915
Provider Name (Legal Business Name): PAIJA BENEBY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MADISON AVE FL 6
NEW YORK NY
10016-6795
US

IV. Provider business mailing address

513 SW VIOLET AVE
PORT ST LUCIE FL
34983-8740
US

V. Phone/Fax

Practice location:
  • Phone: 917-582-6622
  • Fax:
Mailing address:
  • Phone: 561-919-4939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408881
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11047499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: