Provider Demographics
NPI:1659039220
Name:BENZER, ANDRE CAMER (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:CAMER
Last Name:BENZER
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 45TH ST APT 6C
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7015
Mailing Address - Country:US
Mailing Address - Phone:201-562-8047
Mailing Address - Fax:
Practice Address - Street 1:30 E 60TH ST STE 1205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1069
Practice Address - Country:US
Practice Address - Phone:212-996-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NY048212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist