MEDICARE: ELDAD S. BENMEN M.D. P.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1043405640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDAD S. BENMEN M.D. P.C

Provider Business Mailing Address
First Line	:	26021 UNION TPKE
Second Line	:
City	:	GLEN OAKS
State	:	NY
Zip	:	11004-1345
Country	:	US
Telephone Number	:	718-347-4288
Fax Number	:	718-347-7521

Provider Business Practice Location Address
First Line	:	26021 UNION TPKE
Second Line	:
City	:	GLEN OAKS
State	:	NY
Zip	:	11004-1345
Country	:	US
Telephone Number	:	718-347-4288
Fax Number	:	718-347-7521

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELDAD S. BENMEN
Credential	:	M.D.
Telephone Number	:	718-347-4288

Provider Enumeration Date	:	09/07/2007
Last Update Date	:	09/07/2007

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