Active NPI
Raquel Benchoam, MD
- Public Health & General Preventive Medicine Physician
- Bronx, NY
National Provider Identifier
1063851483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 291813
- Practice address
- 4422 3Rd Ave
Dept Internal Medicine Mills 3Rd FL
Bronx, NY 10457-2545 - Phone
- (718) 960-6202
- Fax
- (718) 960-3486
- NPI assigned
- Jun 19, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 291813 | NY | Primary |
Addresses
Primary practice location
4422 3Rd Ave
Dept Internal Medicine Mills 3Rd FL
Bronx, NY 10457-2545
Mailing address
4422 3Rd Ave
Dept Internal Medicine Mills 3Rd FL
Bronx, NY 10457-2545
Phone (718) 960-6202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 291813 | NY | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520467200000",
"number": "1063851483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4422 3RD AVE",
"address_2": "DEPT INTERNAL MEDICINE MILLS 3RD FL",
"city": "BRONX",
"state": "NY",
"postal_code": "104572545",
"telephone_number": "718-960-6202",
"fax_number": "718-960-3486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 3RD AVE",
"address_2": "DEPT INTERNAL MEDICINE MILLS 3RD FL",
"city": "BRONX",
"state": "NY",
"postal_code": "104572545",
"telephone_number": "718-960-6202",
"fax_number": "718-960-3486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENCHOAM",
"first_name": "RAQUEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-19",
"last_updated": "2018-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "NY",
"license": "291813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.