Individual provider Active NPI

Paul Abraham Benjamin

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1821515321
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063321 Issued in NY
Practice address
127 Wainwright Avenue
Staten Island, NY 10312
Phone
(917) 474-0107
NPI assigned
Aug 24, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063321 NY Primary

Addresses

Primary practice location

127 Wainwright Avenue
Staten Island, NY 10312

Mailing address

127 Wainwright Ave
Staten Island, NY 10312-2037
Phone (917) 474-0107

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

LicenseStateTypeSpecialty
063321NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821515321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WAINWRIGHT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122037",
            "telephone_number": "917-474-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 WAINWRIGHT AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10312",
            "telephone_number": "917-474-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "PAUL",
        "middle_name": "ABRAHAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.