Provider Demographics
NPI:1710245345
Name:MINKINS, BENJAMIN
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:MINKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 CROFFUT PL SE APT 303
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-8265
Mailing Address - Country:US
Mailing Address - Phone:202-696-2475
Mailing Address - Fax:
Practice Address - Street 1:2312 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2829
Practice Address - Country:US
Practice Address - Phone:202-636-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide