Provider Demographics
NPI:1316812944
Name:ENCARNACION, BENNY
Entity type:Individual
Prefix:
First Name:BENNY
Middle Name:
Last Name:ENCARNACION
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 1:4866 ONEIL BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-2925
Mailing Address - Country:US
Mailing Address - Phone:939-223-3143
Mailing Address - Fax:
Practice Address - Street 1:4866 ONEIL BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-2925
Practice Address - Country:US
Practice Address - Phone:939-223-3143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker