Provider Demographics
NPI:1275617490
Name:BENIQUEZ, ROSA MARIA (RN)
Entity Type:Individual
Prefix:PROF
First Name:ROSA
Middle Name:MARIA
Last Name:BENIQUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 BARNES AVE
Mailing Address - Street 2:APT # 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1333
Mailing Address - Country:US
Mailing Address - Phone:718-960-2875
Mailing Address - Fax:718-960-2877
Practice Address - Street 1:1225 GERARD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-8001
Practice Address - Country:US
Practice Address - Phone:718-960-2875
Practice Address - Fax:718-960-2877
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444579-1163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory