Basic Information
| Provider Information | |||||||||
| NPI: | 1093336927 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENJAMIN | ||||||||
| FirstName: | SHIBIN | ||||||||
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| Credential: | RRT, CRT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2544 GLENN AVE | ||||||||
| Address2: | |||||||||
| City: | BENSALEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190202324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567259276 | ||||||||
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| Practice Location | |||||||||
| Address1: | 700 LAWN AVE | ||||||||
| Address2: | |||||||||
| City: | SELLERSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189601548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154534000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2020 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 227900000X | YM015888 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered |
No ID Information.