NPIMap

Organization Active NPI

Benzaquen Psychological Services, PLLC

  • Clinical Psychologist
  • Cedarhurst, NY
National Provider Identifier
1710079751
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9097-1 Issued in NY
Legal business name
BENZAQUEN PSYCHOLOGICAL SERVICES, PLLC
Doing business as
Benzaquen Psychological Services, PLLC
Practice address
143 Maple Ave
Cedarhurst, NY 11516-2225
Phone
(516) 295-4104
Fax
(516) 764-7833
NPI assigned
Sep 28, 2006
Last updated
Aug 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Isaac Benzaquen, PHDNPI 1922003110
Title
Managing Member
Phone
(516) 295-4104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 9097-1 NY Primary

Addresses

Primary practice location

143 Maple Ave
Cedarhurst, NY 11516-2225

Mailing address

3229 Perry Ave
Oceanside, NY 11572-4233
Phone (516) 295-4104

Other names 1

  • Benzaquen Psychological Services, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070516000202 NY Part B Supplier - Clinic/Group Practice 4688771298 Receives reassigned benefits from 5 practitioners
Practice locations: Cedarhurst, NY; Far Rockaway, NY; Long Beach, NY

National Provider Directory

National Provider Directory

Locations

143 Maple Ave
Cedarhurst, NY 11516
Phone (516) 295-4104

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1710079751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 PERRY AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115724233",
            "telephone_number": "516-295-4104",
            "fax_number": "516-764-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 MAPLE AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162225",
            "telephone_number": "516-295-4104",
            "fax_number": "516-764-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENZAQUEN PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "BENZAQUEN",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "516-295-4104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "9097-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benzaquen Psychological Services, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedarhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.