Provider Demographics
NPI:1104292143
Name:AYDIN, BEN
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:AYDIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 ALTA DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5632
Mailing Address - Country:US
Mailing Address - Phone:484-350-3075
Mailing Address - Fax:484-351-0530
Practice Address - Street 1:1541 ALTA DR
Practice Address - Street 2:SUITE 304
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5632
Practice Address - Country:US
Practice Address - Phone:484-350-3075
Practice Address - Fax:484-351-0530
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27053601372600000X, 373H00000X, 3747P1801X, 374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide