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General NPI Number Information
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NPI Number | 1245328186
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Entity Type | Individual
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Provider Name | ALEXANDER BENENSON M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3043 OCEAN AVE STE 107
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City | BROOKLYN
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State | NY
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Zip | 11235-3400
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Country | US
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Telephone | 718-891-2727
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Fax | 718-891-2797
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Provider Business Mailing Address
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Address Line | 3043 OCEAN AVE STE 107
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City | BROOKLYN
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State | NY
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Zip | 11235-3400
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Country | US
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Telephone | 718-891-2727
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Fax | 718-891-2797
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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 | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 171168
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License Number State | NY
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