Provider Demographics
NPI:1457328775
Name:BENJAMIN, ALINE SAAD (MD)
Entity Type:Individual
Prefix:MRS
First Name:ALINE
Middle Name:SAAD
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4139
Mailing Address - Country:US
Mailing Address - Phone:718-627-6568
Mailing Address - Fax:
Practice Address - Street 1:624 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2236
Practice Address - Country:US
Practice Address - Phone:718-336-5025
Practice Address - Fax:718-336-1183
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-06
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203699207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG35710Medicare UPIN
NY942961Medicare ID - Type Unspecified