Provider Demographics
NPI:1083840656
Name:BEN-DAN, AHAVAH
Entity Type:Individual
Prefix:
First Name:AHAVAH
Middle Name:
Last Name:BEN-DAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RODMAN PL
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1508
Mailing Address - Country:US
Mailing Address - Phone:845-354-1084
Mailing Address - Fax:845-362-7710
Practice Address - Street 1:7 RODMAN PL
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1508
Practice Address - Country:US
Practice Address - Phone:845-354-1084
Practice Address - Fax:845-362-7710
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012940-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist