Provider Demographics
NPI:1770804650
Name:HIM, BENJAMIN (MED)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:HIM
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100A HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4251
Mailing Address - Country:US
Mailing Address - Phone:978-682-5276
Mailing Address - Fax:978-685-1677
Practice Address - Street 1:100A HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4251
Practice Address - Country:US
Practice Address - Phone:978-682-5276
Practice Address - Fax:978-685-1677
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor