Provider Demographics
NPI:1720069958
Name:BENINCASA, JOSEPH FRANK (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANK
Last Name:BENINCASA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1519
Mailing Address - Country:US
Mailing Address - Phone:516-437-7396
Mailing Address - Fax:516-354-3375
Practice Address - Street 1:107 MEACHAM AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2630
Practice Address - Country:US
Practice Address - Phone:516-354-2950
Practice Address - Fax:516-354-3375
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist