Provider Demographics
NPI:1629015458
Name:BENHAMOU, SOL (MD)
Entity Type:Individual
Prefix:
First Name:SOL
Middle Name:
Last Name:BENHAMOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-0270
Mailing Address - Country:US
Mailing Address - Phone:631-264-2035
Mailing Address - Fax:631-264-1418
Practice Address - Street 1:4500 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2205
Practice Address - Country:US
Practice Address - Phone:718-670-5631
Practice Address - Fax:718-670-4446
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176884207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01114263Medicaid
E41669Medicare UPIN
NY0476SSMedicare PIN
NY0476SWMedicare PIN
NY9K0141Medicare PIN
NY01114263Medicaid
NY0476SNMedicare PIN
NY0476SQMedicare PIN
NY07111RMedicare PIN
NY0476SMMedicare PIN
NY047BBDMedicare PIN
NY047BBEMedicare PIN
NC0476SLMedicare PIN
NY0476SUMedicare PIN
NY0476SKMedicare PIN
NY0476SPMedicare PIN
NY0476STMedicare PIN
NY0476SVMedicare PIN
NY07110NMedicare PIN