Provider Demographics
NPI:1184449746
Name:BENJAMIN, ALIYA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALIYA
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306881
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00803-6881
Mailing Address - Country:US
Mailing Address - Phone:340-677-3597
Mailing Address - Fax:
Practice Address - Street 1:1001 ESTATE ROSS STE 6
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-4601
Practice Address - Country:US
Practice Address - Phone:340-677-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI302225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist