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General NPI Number Information
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NPI Number | 1265945836
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Entity Type | Organization
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Legal Business Name | BENJEVO MGT INC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 2 TOMPKINS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2621
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Country | US
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Telephone | 718-448-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TOMPKINS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DZEVAHIRE NELOVIC
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Credential |
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Telephone | 718-448-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | B00965
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License Number State | NY
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