Provider Demographics
NPI:1548431687
Name:BERENFELD, BENJAMIN (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:BERENFELD
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 1:600 MAMARONECK AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1635
Mailing Address - Country:US
Mailing Address - Phone:914-686-0111
Mailing Address - Fax:914-686-8964
Practice Address - Street 1:600 MAMARONECK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1635
Practice Address - Country:US
Practice Address - Phone:914-686-0111
Practice Address - Fax:914-686-8964
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247593-1207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400002307Medicare PIN