Healthcare Provider Details

I. General information

NPI: 1144184003
Provider Name (Legal Business Name): BENJAMIN HUYNH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6147 PEBBLEBROOK LN
NORTH OLMSTED OH
44070-4572
US

IV. Provider business mailing address

5300 WAYNE ST APT C
RALEIGH NC
27606-3452
US

V. Phone/Fax

Practice location:
  • Phone: 440-652-5156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: