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General NPI Number Information
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NPI Number | 1780048686
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Entity Type | Organization
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Legal Business Name | BENJAMIN STRAUB LLC
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 16 GUION PL MONTEFIORE NEW ROCHELLE HOSPITAL
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5502
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Country | US
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Telephone | 914-365-3997
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-0270
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Country | US
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Telephone | 631-264-2035
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Fax | 631-264-1418
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN STRAUB
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Credential | MD
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Telephone | 631-264-2035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 276045
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License Number State | NY
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