Individual
ESTEBAN A BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8616 JAMAICA AVE, WOODHAVEN, NY 11421-2042
(718) 805-0037
Mailing address
4850 37TH ST APT 2G, LONG ISLAND CITY, NY 11101-1927
(347) 393-7315
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
P84971
NY
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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