Individual
BENJAMIN FAND
Active
Individual
BENJAMIN FAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA04379500
NJ
208800000X
Urology Physician
Primary
25MA04379500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563086
AENTA HMO ID #
NJ
01
—
30D141
EMPIRE BC/BS OF NY EDISON
NY
01
—
30D142
EMPIRE BC/BS OF NY OB
NY
01
—
340005179
RR MEDICARE ID #
NJ
01
—
4229622
AETNA PPO ID #
NJ
01
—
5709961
GHI PPO ID #
NJ
01
—
MS186
OXFORD ID #
NJ
Enumeration date
08/15/2006
Last updated
03/09/2022
Update your record
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