Provider Demographics
NPI:1518167824
Name:D'SOUZA, BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:D'SOUZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 RT 70
Mailing Address - Street 2:STE 260
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-0300
Mailing Address - Country:US
Mailing Address - Phone:856-216-0300
Mailing Address - Fax:856-216-7142
Practice Address - Street 1:1865 RT 70
Practice Address - Street 2:STE 260
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-0300
Practice Address - Country:US
Practice Address - Phone:856-216-0300
Practice Address - Fax:856-216-7142
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439701207RC0001X
NJ25MA09592800207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology