MEDICARE: EVANGELINE J BENITEZ

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	104100000X	Social Worker	091183-1	NY
2	1041S0200X	School Social Worker	1172895	NY
3	1041C0700X	Clinical Social Worker	102340	NY

General Provider Information

NPI Number	:	1265928618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVANGELINE J BENITEZ

Provider Business Mailing Address
First Line	:	669 MAIN ST UNIT 408
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-7101
Country	:	US
Telephone Number	:	929-701-6676
Fax Number	:

Provider Business Practice Location Address
First Line	:	9520 63RD RD STE J
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-1145
Country	:	US
Telephone Number	:	718-282-0010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	03/06/2026

Similar Medicare Providers

1528027067 — DR. NEAL M. LISANN M.D.
Practice Location Address:

9520 63RD RD STE H
REGO PARK, NY
11374-1145

Practice Phone: 718-755-0656
Practice Fax: 866-310-5525

1134180136 — MS. VANESSA BLACKWOOD ACEVEDO LCSW
Practice Location Address:

9520 63RD RD , SUITE J 2ND FLOOR
REGO PARK, NY
11374-1145

Practice Phone: 718-459-1225
Practice Fax:

1821018359 — NAGMO M FATAKHOVA M.D.
Practice Location Address:

9520 63RD RD STE J
REGO PARK, NY
11374-1145

Practice Phone: 858-279-1223
Practice Fax: 619-516-4757

1851407563 — BORINA HOME CARE AGENCY, INC
Practice Location Address:

9520 63RD RD STE J
REGO PARK, NY
11374-1145

Practice Phone: 718-997-7070
Practice Fax: 718-997-8989

1518035732 — EDWARD SHALTS MD
Practice Location Address:

9520 63RD RD STE H
REGO PARK, NY
11374-1145

Practice Phone: 718-864-2120
Practice Fax: 888-603-6374

1205018157 — ALL-CITY HEALTH CARE SERVICES AGENCY, INC.
Practice Location Address:

9520 63RD RD , SUITE 201
REGO PARK, NY
11374-1145

Practice Phone: 718-897-3656
Practice Fax:

Directions to “ EVANGELINE J BENITEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.