Provider Demographics
NPI:1659969251
Name:BENJAMIN, RONISE (RN)
Entity Type:Individual
Prefix:
First Name:RONISE
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 W 142ND ST APT 59B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-3577
Mailing Address - Country:US
Mailing Address - Phone:917-254-2587
Mailing Address - Fax:
Practice Address - Street 1:148 W 142ND ST APT 59B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-3577
Practice Address - Country:US
Practice Address - Phone:917-254-2587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst