Provider Demographics
NPI:1801843701
Name:PASCHKES, BENJAMIN NEIL (DO)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:NEIL
Last Name:PASCHKES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9200
Mailing Address - Fax:856-310-5603
Practice Address - Street 1:200 TRENTON RD
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-1705
Practice Address - Country:US
Practice Address - Phone:609-621-2074
Practice Address - Fax:856-824-1403
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB76815207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60057724OtherHORIZON NJ HEALTH - NON PAR
NJ2296480000OtherAMERIHEALTH
NJ0034169Medicaid
NJ2296480000OtherAMERIHEALTH
NJ082507XZMMedicare PIN
I07799Medicare UPIN
NJ0034169Medicaid