Individual
DR. BENJAMIN MCCOMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
635 W 165TH ST, INTENSIVE OUTPATIENT PROGRAM, NEW YORK, NY 10032-3724
(212) 305-9758
Mailing address
300 CENTRAL PARK W APT 1K, NEW YORK, NY 10024-1590
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
214379
NY
Other
Enumeration date
07/01/2006
Last updated
07/08/2007
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