Provider Demographics
NPI:1669671129
Name:JAMES-BENJAMIN, ADELE (RN, MBA)
Entity Type:Individual
Prefix:MRS
First Name:ADELE
Middle Name:
Last Name:JAMES-BENJAMIN
Suffix:
Gender:F
Credentials:RN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 APPLE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6804
Mailing Address - Country:US
Mailing Address - Phone:845-342-8843
Mailing Address - Fax:
Practice Address - Street 1:16 APPLE LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6804
Practice Address - Country:US
Practice Address - Phone:845-342-8843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY515611-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02158583Medicaid