Provider Demographics
NPI:1982434882
Name:BENJAMIN, MICHECA (CNM)
Entity type:Individual
Prefix:
First Name:MICHECA
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MICHECA
Other - Middle Name:
Other - Last Name:BENJAMIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:379 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1161
Mailing Address - Country:US
Mailing Address - Phone:732-937-8939
Mailing Address - Fax:732-418-8372
Practice Address - Street 1:200 WILLIAMSON ST STE 350
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-2909
Practice Address - Country:US
Practice Address - Phone:908-994-5500
Practice Address - Fax:908-994-5815
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ176B00000X
NJ25ME00087400367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife