Provider Demographics
NPI:1609873041
Name:BENZAKEIN, RALPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:BENZAKEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2303
Mailing Address - Country:US
Mailing Address - Phone:718-998-1375
Mailing Address - Fax:718-339-2839
Practice Address - Street 1:2241 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2303
Practice Address - Country:US
Practice Address - Phone:718-998-1375
Practice Address - Fax:718-339-2839
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN-003697-01213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1301800001OtherNEDICARE DMERC
NY00881163Medicaid
NYT51220Medicare UPIN
NY00881163Medicaid