Provider Demographics
NPI:1285130187
Name:BENCOSME, GLADYS S
Entity type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:S
Last Name:BENCOSME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WHITE ST APT 24
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3646
Mailing Address - Country:US
Mailing Address - Phone:914-826-5157
Mailing Address - Fax:
Practice Address - Street 1:50 WHITE ST APT 24
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-3646
Practice Address - Country:US
Practice Address - Phone:914-826-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2018-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist