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Individual

MR. ANDY M BENEJAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW-R

Contact information

Practice address
1650 GRAND CONCOURSE, BRONX LEBANON HOSPITAL, BRONX, NY 10457-7606
(718) 960-2059
(718) 466-8190
Mailing address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 960-2059

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R049984
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01929973
NY
Enumeration date
01/19/2007
Last updated
01/27/2017
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