Provider Demographics
NPI:1992006027
Name:PHILIP, BENOY
Entity Type:Individual
Prefix:
First Name:BENOY
Middle Name:
Last Name:PHILIP
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:BENOY
Other - Middle Name:
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:40 MAPLE TER
Mailing Address - Street 2:CLIFTON HTS
Mailing Address - City:CLIFTON HTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-1613
Mailing Address - Country:US
Mailing Address - Phone:610-259-2954
Mailing Address - Fax:
Practice Address - Street 1:640 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2031
Practice Address - Country:US
Practice Address - Phone:610-664-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist