Provider Demographics
NPI:1093512907
Name:ARCONA, BENJAMIN ANTHONY (DPT)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ANTHONY
Last Name:ARCONA
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 GREYSTONE LN APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5979
Mailing Address - Country:US
Mailing Address - Phone:908-914-5955
Mailing Address - Fax:
Practice Address - Street 1:302 GREYSTONE LN APT 2B
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5979
Practice Address - Country:US
Practice Address - Phone:908-914-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0015033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist