Provider Demographics
NPI:1699434167
Name:SZAFRAN, BENJAMIN JAMES
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JAMES
Last Name:SZAFRAN
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 1:1466 S COLT DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-7344
Mailing Address - Country:US
Mailing Address - Phone:602-318-4380
Mailing Address - Fax:
Practice Address - Street 1:1466 S COLT DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-7344
Practice Address - Country:US
Practice Address - Phone:602-318-4380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ238920363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care