Provider Demographics
NPI:1467996389
Name:BENATAR, LEAH SARA
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:SARA
Last Name:BENATAR
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 1:16 ALGONQUIN CIR.
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:845-608-1446
Mailing Address - Fax:
Practice Address - Street 1:105 SCHUNNEMUNK RD
Practice Address - Street 2:112
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-6104
Practice Address - Country:US
Practice Address - Phone:845-477-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP04443103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst