Individual
BENJAMIN ARI HAGENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
276096
NY
208600000X
Surgery Physician
MD-16466
HI
2086S0102X
Surgical Critical Care Physician
25MA07594200
NJ
2086S0102X
Surgical Critical Care Physician
276096
NY
2086S0102X
Surgical Critical Care Physician
MD-16466
HI
2086S0127X
Trauma Surgery Physician
25MA07594200
NJ
2086S0127X
Trauma Surgery Physician
Primary
276096
NY
2086S0127X
Trauma Surgery Physician
MD-16466
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0207551
—
NY
01
—
276096
MEDICAL LICENSE
NY
01
—
MA07594200
MEDICAL LICENSE
NJ
01
—
MD-16466
MEDICAL LICENSE
HI
Enumeration date
06/27/2007
Last updated
04/26/2017
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