Provider Demographics
NPI:1477182384
Name:ASRIEL, BENJAMIN FORD (MD, MFA)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:FORD
Last Name:ASRIEL
Suffix:
Gender:M
Credentials:MD, MFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5674
Mailing Address - Country:US
Mailing Address - Phone:212-824-8054
Mailing Address - Fax:212-426-1946
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5674
Practice Address - Country:US
Practice Address - Phone:212-824-8054
Practice Address - Fax:212-426-1946
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program