Healthcare Provider Details

I. General information

NPI: 1396674784
Provider Name (Legal Business Name): INGRID BENITEZ LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WESTCHESTER AVE STE 305
WHITE PLAINS NY
10604-3536
US

IV. Provider business mailing address

32 CHELSEA RIDGE DR APT B
WAPPINGERS FALLS NY
12590-5640
US

V. Phone/Fax

Practice location:
  • Phone: 914-997-0420
  • Fax:
Mailing address:
  • Phone: 914-997-0420
  • Fax: 877-306-1432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number354291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: