Provider Demographics
NPI:1508479320
Name:BENSON, DANICA BROOKLYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:BROOKLYN
Last Name:BENSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27A MARTINE CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-6003
Mailing Address - Country:US
Mailing Address - Phone:484-764-4324
Mailing Address - Fax:
Practice Address - Street 1:3801 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2215
Practice Address - Country:US
Practice Address - Phone:302-762-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0015533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0015533OtherPHARMACIST LICENSE