| Benzaquen Psychological Services, Pllc | |
|
143 Maple Ave Cedarhurst NY 11516-2225 | |
| (516) 295-4104 | |
| (516) 764-7833 |
| Full Name | Benzaquen Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 143 Maple Ave, Cedarhurst, New York |
| Authorized Official Name and Position | Isaac Benzaquen (MANAGING MEMBER) |
| Authorized Official Contact | 5162954104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benzaquen Psychological Services, Pllc 3229 Perry Ave Oceanside NY 11572-4233 Ph: (516) 295-4104 | Benzaquen Psychological Services, Pllc 143 Maple Ave Cedarhurst NY 11516-2225 Ph: (516) 295-4104 |
| NPI Number | 1710079751 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/10/2007 |
| Medicare PECOS PAC ID | 4688771298 |
|---|---|
| Medicare Enrollment ID | O20070516000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710079751 | NPI | - | NPPES |
| 02870166 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 9097-1 (New York) | Primary |
| Provider Name | Irina Vakhnyanskaya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285663963 PECOS PAC ID: 0941214829 Enrollment ID: I20060131000075 |
| Provider Name | Isaac Benzaquen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922003110 PECOS PAC ID: 6406958925 Enrollment ID: I20070301000089 |
| Provider Name | Richard Waxman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972665164 PECOS PAC ID: 8022198324 Enrollment ID: I20071227000378 |
| Provider Name | Ruth M Mutzner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982640835 PECOS PAC ID: 3476618786 Enrollment ID: I20090220000467 |
| Provider Name | Judy C Hwang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104081850 PECOS PAC ID: 7012103872 Enrollment ID: I20101119000377 |
| Provider Name | Patricia A Murray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992926521 PECOS PAC ID: 2769671759 Enrollment ID: I20110106000283 |
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