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NPI Code Detail

MEDICARE: MR. GARY BENJAMIN SR.

MEDICARE: MR. GARY BENJAMIN SR.
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1235076118
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GARY BENJAMIN SR.
Provider Business Mailing Address
First Line : 2866 STACEY ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-4220
Country : US
Telephone Number : 330-951-8126
Fax Number :
Provider Business Practice Location Address
First Line : 2866 STACEY ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-4220
Country : US
Telephone Number : 330-951-8126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2026
Last Update Date : 04/30/2026

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