Provider Demographics
NPI:1235599754
Name:BENCHICH, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BENCHICH
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 1:9643 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-1552
Mailing Address - Country:US
Mailing Address - Phone:313-282-3813
Mailing Address - Fax:
Practice Address - Street 1:9643 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-1552
Practice Address - Country:US
Practice Address - Phone:313-282-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist