Provider Demographics
NPI:1720864895
Name:BENINATE, ISABELLA (CF-SLP)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:BENINATE
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 ADOLPHUS AVE APT 417
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2851
Mailing Address - Country:US
Mailing Address - Phone:504-701-6892
Mailing Address - Fax:
Practice Address - Street 1:59 BEAVERBROOK RD STE 303C
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-1772
Practice Address - Country:US
Practice Address - Phone:848-256-6943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-4156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist