Provider Demographics
NPI:1982896916
Name:PHILIP, BENSON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BENSON
Middle Name:
Last Name:PHILIP
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1825 EASTCHESTER RD
Mailing Address - Street 2:DEPARTMENT OF GENERAL SURGERY 2S-5
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2301
Mailing Address - Country:US
Mailing Address - Phone:718-904-2260
Mailing Address - Fax:718-904-4183
Practice Address - Street 1:1825 EASTCHESTER RD
Practice Address - Street 2:DEPARTMENT OF GENERAL SURGERY 2S-5
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-904-2260
Practice Address - Fax:718-904-4183
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP45912363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical