Provider Demographics
NPI:1073591137
Name:BEN-YEHUDA, RINA (PT)
Entity Type:Individual
Prefix:MRS
First Name:RINA
Middle Name:
Last Name:BEN-YEHUDA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 RIVERSIDE DR
Mailing Address - Street 2:APT. 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3708
Mailing Address - Country:US
Mailing Address - Phone:212-877-9688
Mailing Address - Fax:212-769-3757
Practice Address - Street 1:115 W 86TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3410
Practice Address - Country:US
Practice Address - Phone:646-388-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012419-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ28A01Medicare ID - Type Unspecified