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Individual

DR. JESSICA L BENLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
35 DOCK ST, YONKERS, NY 10701-2733
(914) 965-1109
(914) 965-9705
Mailing address
19 GREENRIDGE AVE, WHITE PLAINS, NY 10605-1201
(914) 965-1109
(914) 997-7942

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
019312
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00355940
AGENCY MEDICAID PROVIDER ID
NY
01
1285628552
AGENCY NPI #
NY
01
WVE061
AGENCY MEDICARE #
NY
Enumeration date
08/04/2009
Last updated
10/04/2011
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