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General NPI Number Information
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NPI Number | 1063851483
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Entity Type | Individual
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Provider Name | RAQUEL BENCHOAM MD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 4422 3RD AVE DEPT INTERNAL MEDICINE MILLS 3RD FL
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City | BRONX
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State | NY
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Zip | 10457-2545
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Country | US
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Telephone | 718-960-6202
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Fax | 718-960-3486
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Provider Business Mailing Address
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Address Line | 4422 3RD AVE DEPT INTERNAL MEDICINE MILLS 3RD FL
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City | BRONX
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State | NY
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Zip | 10457-2545
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Country | US
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Telephone | 718-960-6202
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Fax | 718-960-3486
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 291813
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License Number State | NY
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