Provider Demographics
NPI:1609938190
Name:BENATAR, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:BENATAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 MERRICK RD
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 RD
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
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY186811207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY69G061Medicare ID - Type Unspecified
NYG08085Medicare UPIN