Provider Demographics
NPI:1861817389
Name:BENCIVENGA, JAMES N (MA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:N
Last Name:BENCIVENGA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 ASHTON ST
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1302
Mailing Address - Country:US
Mailing Address - Phone:201-294-4404
Mailing Address - Fax:
Practice Address - Street 1:425 AMWELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1213
Practice Address - Country:US
Practice Address - Phone:908-770-7352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0356935Medicaid