Provider Demographics
NPI:1629390497
Name:BENJAMIN, HANY W (RPH)
Entity Type:Individual
Prefix:MR
First Name:HANY
Middle Name:W
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OLD PALISADE RD
Mailing Address - Street 2:APT. 709
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7064
Mailing Address - Country:US
Mailing Address - Phone:201-482-4893
Mailing Address - Fax:
Practice Address - Street 1:100 OLD PALISADE RD
Practice Address - Street 2:APT. 709
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7064
Practice Address - Country:US
Practice Address - Phone:201-482-4893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist