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General NPI Number Information
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NPI Number | 1730293739
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Entity Type | Individual
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Provider Name | PAUL S. BENVENISTE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 75 RAILROAD PL
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-2124
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Country | US
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Telephone | 518-321-3613
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Fax | 518-792-5235
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Provider Business Mailing Address
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Address Line | 2 FIELDVIEW RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-7770
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Country | US
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Telephone | 518-321-2060
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Fax | 518-792-5235
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 012638
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License Number State | NY
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