Provider Demographics
NPI:1942965579
Name:BENSON, ISIA RECH PEMBE
Entity Type:Individual
Prefix:
First Name:ISIA RECH
Middle Name:PEMBE
Last Name:BENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ISIA RECH
Other - Middle Name:
Other - Last Name:NZIKOU PEMBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 THE AVE # B
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4621
Mailing Address - Country:US
Mailing Address - Phone:585-713-4845
Mailing Address - Fax:
Practice Address - Street 1:36 THE AVE # B
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4621
Practice Address - Country:US
Practice Address - Phone:585-713-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula