Provider Demographics
NPI:1346552387
Name:ANARAFENA MEDICAL, PLLC
Entity Type:Organization
Organization Name:ANARAFENA MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AZRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENAROYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-406-4966
Mailing Address - Street 1:21757 KINGSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3534
Mailing Address - Country:US
Mailing Address - Phone:917-406-4966
Mailing Address - Fax:
Practice Address - Street 1:3819 UNION ST
Practice Address - Street 2:STE. 301
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5587
Practice Address - Country:US
Practice Address - Phone:917-563-5871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185149174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01366792Medicaid
NY5325RSMedicare PIN