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General NPI Number Information
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NPI Number | 1053711432
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Entity Type | Individual
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Provider Name | BENJAMIN OH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 44 N CENTRAL AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-3817
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Country | US
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Telephone | 516-872-6861
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Fax |
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Provider Business Mailing Address
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Address Line | 24054 69TH AVE 2ND FLOOR
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City | DOUGLASTON
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State | NY
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Zip | 11362-1944
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Country | US
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Telephone | 917-295-4200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 059826
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License Number State | NY
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