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General NPI Number Information
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NPI Number | 1790669968
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Entity Type | Individual
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Provider Name | BENJAMIN ILAN DUKAS PSYD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 225 BROADWAY STE 2010
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City | NEW YORK
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State | NY
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Zip | 10007-3738
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Country | US
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Telephone | 212-899-5069
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Fax | 347-745-3166
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Provider Business Mailing Address
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Address Line | 225 BROADWAY STE 2010
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City | NEW YORK
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State | NY
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Zip | 10007-3738
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Country | US
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Telephone | 212-899-5069
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Fax | 347-745-3166
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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 | P137181
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License Number State | NY
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