Provider Demographics
NPI:1578995536
Name:BENATTAR, MAYA (MA, MT-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:BENATTAR
Suffix:
Gender:F
Credentials:MA, MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 46TH ST
Mailing Address - Street 2:APT 3S
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1870
Mailing Address - Country:US
Mailing Address - Phone:914-330-9545
Mailing Address - Fax:
Practice Address - Street 1:4130 46TH ST
Practice Address - Street 2:APT 3S
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1870
Practice Address - Country:US
Practice Address - Phone:914-330-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001407225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist