Healthcare Provider Details

I. General information

NPI: 1841983897
Provider Name (Legal Business Name): YOLISEPT CELAINE BENCOSME DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 WESTCHESTER AVE STE 208
PURCHASE NY
10577-2524
US

IV. Provider business mailing address

257 EDWARDS PL
YONKERS NY
10703-2342
US

V. Phone/Fax

Practice location:
  • Phone: 914-939-4101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number007553
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: