Organization
BENZAQUEN PSYCHOLOGICAL SERVICES, PLLC
Active
Other names
Benzaquen Psychological Services, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC BENZAQUEN PHD (MANAGING MEMBER)
(516) 295-4104
Entity
Organization
Contact information
Practice address
143 MAPLE AVE, CEDARHURST, NY 11516-2225
(516) 295-4104
(516) 764-7833
Mailing address
3229 PERRY AVE, OCEANSIDE, NY 11572-4233
(516) 295-4104
(516) 764-7833
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9097-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02870166
—
NY
Enumeration date
09/28/2006
Last updated
08/10/2007
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