Provider Demographics
NPI:1659582922
Name:OAKES, BENJAMIN A (RPA-C)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:A
Last Name:OAKES
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MADISON AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3218
Mailing Address - Country:US
Mailing Address - Phone:607-734-1581
Mailing Address - Fax:607-734-0972
Practice Address - Street 1:200 MADISON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3218
Practice Address - Country:US
Practice Address - Phone:607-734-1581
Practice Address - Fax:607-734-0972
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007515363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP14494Medicare UPIN
NYCC9596Medicare ID - Type Unspecified