Healthcare Provider Details

I. General information

NPI: 1861468647
Provider Name (Legal Business Name): ERNEST BENJAMIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 EAST 98TH ST 14TH FL
NEW YORK NY
10029-6574
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL BOX 1263
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-8867
  • Fax: 212-241-6238
Mailing address:
  • Phone: 212-241-8867
  • Fax: 212-241-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number151080
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number151080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: