Provider Demographics
NPI:1689862906
Name:RALPH BENZAKEIN DPM PC
Entity Type:Organization
Organization Name:RALPH BENZAKEIN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BENZAKEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-998-1375
Mailing Address - Street 1:2241 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2303
Mailing Address - Country:US
Mailing Address - Phone:718-998-1375
Mailing Address - Fax:718-339-2839
Practice Address - Street 1:2241 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2303
Practice Address - Country:US
Practice Address - Phone:718-998-1375
Practice Address - Fax:718-339-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3697-1261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00881163Medicaid
NY1301800001Medicare NSC
NYT51220Medicare UPIN