Provider Demographics
NPI:1891573937
Name:BASRI, BENJAMIN JAMES (LLP)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JAMES
Last Name:BASRI
Suffix:
Gender:M
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 5TH AVE RM 1402
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5034
Mailing Address - Country:US
Mailing Address - Phone:347-460-6570
Mailing Address - Fax:347-329-4333
Practice Address - Street 1:347 5TH AVE RM 1402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5034
Practice Address - Country:US
Practice Address - Phone:347-460-6570
Practice Address - Fax:347-329-4333
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health