Provider Demographics
NPI:1598410698
Name:BENJAMIN, ANDREW S (AA, CBRC, CRC, CCC)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:S
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:AA, CBRC, CRC, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1814
Mailing Address - Country:US
Mailing Address - Phone:347-898-3739
Mailing Address - Fax:
Practice Address - Street 1:147 E 46TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1814
Practice Address - Country:US
Practice Address - Phone:347-898-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2023-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty