Provider Demographics
NPI:1316204084
Name:BEN-ARIE, OFFER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:OFFER
Middle Name:
Last Name:BEN-ARIE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PARADE PL
Mailing Address - Street 2:4K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1003
Mailing Address - Country:US
Mailing Address - Phone:917-860-0587
Mailing Address - Fax:
Practice Address - Street 1:25 PARADE PL
Practice Address - Street 2:4K
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1003
Practice Address - Country:US
Practice Address - Phone:917-860-0587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15539363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant