MEDICARE: MR. HANY W BENJAMIN RPH

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	183500000X	Pharmacist	044839	NY

General Provider Information

NPI Number	:	1629390497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HANY W BENJAMIN RPH

Provider Business Mailing Address
First Line	:	100 OLD PALISADE RD
Second Line	:	APT. 709
City	:	FORT LEE
State	:	NJ
Zip	:	07024-7064
Country	:	US
Telephone Number	:	201-482-4893
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 OLD PALISADE RD
Second Line	:	APT. 709
City	:	FORT LEE
State	:	NJ
Zip	:	07024-7064
Country	:	US
Telephone Number	:	201-482-4893
Fax Number	:

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

Provider Enumeration Date	:	02/22/2010
Last Update Date	:	02/22/2010

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