Provider Demographics
NPI:1649482266
Name:BENZAQUEN, SADIA (MD)
Entity type:Individual
Prefix:DR
First Name:SADIA
Middle Name:
Last Name:BENZAQUEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SADIA
Other - Middle Name:
Other - Last Name:BENZAQUEN WAHNICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 EDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-4231
Mailing Address - Country:US
Mailing Address - Phone:513-475-8523
Mailing Address - Fax:513-475-7327
Practice Address - Street 1:200 EDEN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-8523
Practice Address - Fax:513-475-7327
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X174400000X
OH35.095683207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201000000Medicaid
OH3075925Medicaid
KY7100127320Medicaid
OHBE4302802Medicare PIN