Provider Demographics
NPI:1194873273
Name:BARRAH, BENJAMIN NMEREKE (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:NMEREKE
Last Name:BARRAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13046 LAURELTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1219
Mailing Address - Country:US
Mailing Address - Phone:718-622-2525
Mailing Address - Fax:718-622-7177
Practice Address - Street 1:1545 ATLANTIC AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1122
Practice Address - Country:US
Practice Address - Phone:712-622-2525
Practice Address - Fax:718-622-7177
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234623207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02024106Medicaid
NY836271Medicare ID - Type Unspecified
NY02024106Medicaid