Provider Demographics
NPI:1942312236
Name:BENSIMON, LIRON (PT)
Entity Type:Individual
Prefix:MR
First Name:LIRON
Middle Name:
Last Name:BENSIMON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:LIRAN
Other - Middle Name:
Other - Last Name:BENSIMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:163 MAYHEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1310
Mailing Address - Country:US
Mailing Address - Phone:646-823-6062
Mailing Address - Fax:
Practice Address - Street 1:359 W 23RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2202
Practice Address - Country:US
Practice Address - Phone:212-488-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist