Provider Demographics
NPI:1740773233
Name:BENSHOSHAN, NIR
Entity Type:Individual
Prefix:
First Name:NIR
Middle Name:
Last Name:BENSHOSHAN
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 1:2611 MERRICK RD
Mailing Address - Street 2:#955
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:917-805-2472
Mailing Address - Fax:
Practice Address - Street 1:2611 MERRICK RD
Practice Address - Street 2:#904
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:917-805-2472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist