Individual
MARIELLA BENAVIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(646) 501-7070
Mailing address
559 SAINT JOHNS PL APT 3R, BROOKLYN, NY 11238-5558
(239) 537-4128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
341959
NY
Other
Enumeration date
01/25/2018
Last updated
08/09/2022
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