Individual
DR. HENRY BENVENISTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD CLINICAL PSYCH
Contact information
Practice address
48 N MIDDLETOWN ROAD, MONTVALE, NJ 07645
(201) 391-9467
Mailing address
48 N MIDDLETOWN ROAD, MONTVALE, NJ 07645
(201) 391-9467
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
667PZ8832
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NJ
106H00000X
Marriage & Family Therapist
Primary
37F100036900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059327
GHI OF NY
NY
01
—
103066
VALUE OPTIONS OF NY
NY
05
—
HB699478
—
NJ
01
—
VZ6881
BLUE CROSS
NJ
Enumeration date
02/02/2007
Last updated
08/31/2012
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