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NPI Code Detail

MEDICARE: YURY BENIN PT

MEDICARE: YURY BENIN PT
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
1174400000XSpecialist010179NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235174319
Entity Type Code : Individual
Provider Name (Legal Business Name) : YURY BENIN PT
Provider Business Mailing Address
First Line : 2116 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1507
Country : US
Telephone Number : 718-338-1616
Fax Number : 718-338-1898
Provider Business Practice Location Address
First Line : 2116 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1507
Country : US
Telephone Number : 718-338-1616
Fax Number : 718-338-1898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 07/08/2007

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