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General NPI Number Information
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NPI Number | 1477412062
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Entity Type | Organization
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Legal Business Name | BENJAMIN SUBTELNY LLC
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 6040 BLVD E APT 17G
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-3841
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Country | US
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Telephone | 607-351-0187
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Fax |
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Provider Business Mailing Address
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Address Line | 6040 BLVD E APT 17G
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-3841
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Country | US
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Telephone | 201-509-5648
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Fax | 973-833-4177
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BENJAMIN JOSEPH SUBTELNY
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Credential | DDS
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Telephone | 201-509-5648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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