Provider Demographics
NPI:1699084848
Name:DUNKLEY, BENJAMIN LEWIS (DPT)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:LEWIS
Last Name:DUNKLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1939
Mailing Address - Country:US
Mailing Address - Phone:716-646-7424
Mailing Address - Fax:716-648-7585
Practice Address - Street 1:4650 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1939
Practice Address - Country:US
Practice Address - Phone:716-646-7424
Practice Address - Fax:716-648-7585
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP77739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist