Provider Demographics
NPI:1932760923
Name:BENSON, ALEXIS S
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:S
Last Name:BENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 PONDVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4220
Mailing Address - Country:US
Mailing Address - Phone:856-430-3739
Mailing Address - Fax:
Practice Address - Street 1:55 PONDVIEW LN
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-4220
Practice Address - Country:US
Practice Address - Phone:856-430-3739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion