Provider Demographics
NPI:1568545952
Name:BENZION BENATAR MD PC
Entity Type:Organization
Organization Name:BENZION BENATAR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BENZION
Authorized Official - Middle Name:
Authorized Official - Last Name:BENATAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-785-5350
Mailing Address - Street 1:2631 MERRICK ROAD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5784
Mailing Address - Country:US
Mailing Address - Phone:516-785-5350
Mailing Address - Fax:516-785-4530
Practice Address - Street 1:2631 MERRICK ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5784
Practice Address - Country:US
Practice Address - Phone:516-785-5350
Practice Address - Fax:516-785-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186898207LP2900X
NY086503207X00000X
NY186811207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
186811OtherLICENSE NUMBER
086503OtherLICENSE NUMBER
007162OtherLICENSE NUMBER
186898OtherLICENSE NUMBER
P91048Medicare UPIN
13A441Medicare ID - Type Unspecified
174121Medicare ID - Type Unspecified
007162OtherLICENSE NUMBER
5042L1Medicare ID - Type Unspecified
186898OtherLICENSE NUMBER
F79548Medicare UPIN
C06298Medicare UPIN
186811OtherLICENSE NUMBER