Provider Demographics
NPI:1841364965
Name:BENN, HOWARD A (MD)
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:A
Last Name:BENN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 4394
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-4394
Mailing Address - Country:US
Mailing Address - Phone:973-341-1130
Mailing Address - Fax:877-958-7233
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1422
Practice Address - Country:US
Practice Address - Phone:973-341-1130
Practice Address - Fax:877-958-7233
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08164800174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0119563Medicaid