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General NPI Number Information
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NPI Number | 1346655099
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Entity Type | Individual
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Provider Name | BENJAMIN HELLER
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Gender | Male
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 515 W BUCKEYE RD STE 104
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City | PHOENIX
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State | AZ
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Zip | 85003
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Country | US
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Telephone | 602-257-8280
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Fax | 602-257-7007
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Provider Business Mailing Address
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Address Line | 515 W BUCKEYE RD STE 104
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City | PHOENIX
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State | AZ
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Zip | 85003-3699
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Country | US
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Telephone | 602-692-6908
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Fax | 602-257-7007
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A13378
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 007053
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License Number State | AZ
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