Provider Demographics
NPI:1720821721
Name:HIGGINS, BENJAMIN TRISTAN (DPT)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:TRISTAN
Last Name:HIGGINS
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 1:909 CEDARTREE LN APT 10
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-1665
Mailing Address - Country:US
Mailing Address - Phone:609-553-3441
Mailing Address - Fax:
Practice Address - Street 1:3604 LANCASTER PIKE STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1600
Practice Address - Country:US
Practice Address - Phone:302-691-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist