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General NPI Number Information
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NPI Number | 1831126945
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Entity Type | Individual
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Provider Name | BENYAMIN A HANNALLAH MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/06/2021
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Provider Practice Location Address
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Address Line | 142 PALISADE AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07306-1108
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Country | US
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Telephone | 201-714-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 201 MARIN BLVD APT 1409
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City | JERSEY CITY
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State | NJ
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Zip | 07302-6701
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Country | US
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Telephone | 908-405-9977
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME55056
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License Number State | NJ
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