Individual provider Active NPI

Taina Marcelle Benjamin, LPN

  • Licensed Practical Nurse
  • Pomona, NY
National Provider Identifier
1962829358
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
311407-1 Issued in NY
Practice address
5 Phyllis Dr
Pomona, NY 10970-2629
Phone
(845) 548-6731
Fax
(845) 354-8535
NPI assigned
Mar 24, 2014
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 311407-1 NY Primary

Addresses

Primary practice location

5 Phyllis Dr
Pomona, NY 10970-2629

Mailing address

5 Phyllis Dr
Pomona, NY 10970-2629
Phone (845) 548-6731

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
311407-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1962829358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PHYLLIS DR",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702629",
            "telephone_number": "845-548-6731",
            "fax_number": "845-354-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PHYLLIS DR",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702629",
            "telephone_number": "845-548-6731",
            "fax_number": "845-354-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "TAINA",
        "middle_name": "MARCELLE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "311407-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.