Individual
JOAN MARCY BENKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 HOBART RD, SOUTHOLD, NY 11971-1510
(631) 765-5619
Mailing address
250 HOBART RD, SOUTHOLD, NY 11971-1510
(631) 765-5619
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
377979
NY
363LW0102X
Women's Health Nurse Practitioner
F420374
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11323
LCCE
—
01
—
377979
RN
NY
01
—
F420374
NURSE PRACTITIONER IN WOMEN'S HEALTH
NY
01
—
L-13471
IBCLC
—
Enumeration date
12/17/2018
Last updated
12/17/2018
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