Provider Demographics
NPI:1912102120
Name:CHENEY, BENJAMIN B (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:B
Last Name:CHENEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 43RD ST
Mailing Address - Street 2:SUITE 1703, 17TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4707
Mailing Address - Country:US
Mailing Address - Phone:212-712-8889
Mailing Address - Fax:
Practice Address - Street 1:211 E 43RD ST
Practice Address - Street 2:SUITE 1703, 17TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4707
Practice Address - Country:US
Practice Address - Phone:212-712-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2278202084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry