Taina Marcelle Benjamin, LPN

Individual provider Active NPI Licensed Practical Nurse · Pomona, NY

NPI 1962829358 · NPPES record last updated Mar 24, 2014

Key facts

NPI
1962829358
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
311407-1 (NY)
Practice address
5 Phyllis Dr
Pomona, NY 10970-2629
Phone
(845) 548-6731
Fax
(845) 354-8535
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
311407-1NYMDLicensed Practical Nurse

Specialties & licenses

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

Addresses

Primary practice location

5 Phyllis Dr
Pomona, NY 10970-2629

Mailing address

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

Other providers in Pomona, NY

All providers in Pomona, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.