Provider Demographics
NPI:1235564337
Name:BENJAMIN, RON (DO)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W 21ST ST APT 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3044
Mailing Address - Country:US
Mailing Address - Phone:614-638-3278
Mailing Address - Fax:
Practice Address - Street 1:325 W 21ST ST APT 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3044
Practice Address - Country:US
Practice Address - Phone:614-638-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-08
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2972242085R0202X
NY2015252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology