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General NPI Number Information
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NPI Number | 1134849375
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Entity Type | Individual
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Provider Name | JULIA NOELLE BENCKO
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 2341 NEW HYDE PARK RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1212
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Country | US
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Telephone | 516-806-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 91 TULIP AVE APT CB1
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City | FLORAL PARK
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State | NY
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Zip | 11001-1977
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Country | US
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Telephone | 440-591-9207
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1643429221
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License Number State | NY
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