Provider Demographics
NPI:1619119286
Name:NUMPANG, BEN (MD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:NUMPANG
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 1:280 ROUTE 211 E STE 104-331
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-3109
Mailing Address - Country:US
Mailing Address - Phone:845-239-2953
Mailing Address - Fax:
Practice Address - Street 1:GARNET HEALTH MEDICAL CENTER
Practice Address - Street 2:707 EAST MAIN STREET
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-333-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM-17562080N0001X
UT7279072-12052080N0001X
NY3106682080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine