Provider Demographics
NPI:1184038309
Name:BENCHMARK DIAGNOSTICS
Entity Type:Organization
Organization Name:BENCHMARK DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDUCAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:S
Authorized Official - Last Name:USMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:440-627-2040
Mailing Address - Street 1:6777 ENGLE RD
Mailing Address - Street 2:SUITE M
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7941
Mailing Address - Country:US
Mailing Address - Phone:440-627-2040
Mailing Address - Fax:
Practice Address - Street 1:6777 ENGLE RD
Practice Address - Street 2:SUITE M
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7941
Practice Address - Country:US
Practice Address - Phone:440-627-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078311291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH34026OtherUPIN
OH1568420602OtherNPI