Provider Demographics
NPI:1114311750
Name:BENJAMIN ARTHUR O.D. M.S., PC
Entity Type:Organization
Organization Name:BENJAMIN ARTHUR O.D. M.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:MENLAH
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:OD MS, PC
Authorized Official - Phone:610-772-5321
Mailing Address - Street 1:629 EASTERN PKWY
Mailing Address - Street 2:UNIT #M4 (202)
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:629 EASTERN PKWY
Practice Address - Street 2:UNIT #M4 (202)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3354
Practice Address - Country:US
Practice Address - Phone:347-450-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 007997152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty