Provider Demographics
NPI:1952472334
Name:BENENSON, BLANCHE S (MD)
Entity Type:Individual
Prefix:
First Name:BLANCHE
Middle Name:S
Last Name:BENENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1119
Mailing Address - Country:US
Mailing Address - Phone:718-839-7038
Mailing Address - Fax:718-862-1845
Practice Address - Street 1:1225 MORRIS PARK AVE
Practice Address - Street 2:RFK-CERC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-839-7038
Practice Address - Fax:718-862-1845
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY176595208000000X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics