Active NPI
Amanda Benjamin
- Optician
- Montclair, NJ
National Provider Identifier
1720436884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 31TD00383400
- Practice address
- 11 Seymour St Apt 15
Montclair, NJ 07042-3332 - Phone
- (862) 218-7415
- NPI assigned
- May 31, 2016
- Last updated
- May 31, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 31TD00383400 | NJ | Primary |
Addresses
Primary practice location
11 Seymour St Apt 15
Montclair, NJ 07042-3332
Mailing address
11 Seymour St Apt 15
Montclair, NJ 07042-3332
Phone (862) 218-7415
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31TD00383400 | NJ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464652800000",
"number": "1720436884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SEYMOUR ST APT 15",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423332",
"telephone_number": "862-218-7415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 SEYMOUR ST APT 15",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423332",
"telephone_number": "862-218-7415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2016-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NJ",
"license": "31TD00383400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.