Provider Demographics
NPI:1043950181
Name:BENKHOUKHA, AMINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMINA
Middle Name:
Last Name:BENKHOUKHA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 MINNIEFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10464-1230
Mailing Address - Country:US
Mailing Address - Phone:786-252-8311
Mailing Address - Fax:
Practice Address - Street 1:901 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4157
Practice Address - Country:US
Practice Address - Phone:646-351-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP107864103TC0700X
NY025302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025302Medicaid
NY025302OtherUNRESTRICTED LICENSE