NPI 1124336821

Benjamin Mark Eberlein, CNA

Practitioner Nurse's Aide Hollis, NY

Practice location

Address: 8712 Clio St, Hollis, NY 11423-1200
Phone: (703) 863-5325

Registered specialties

Nurse's Aide Primary

Nursing Service Related Providers Taxonomy 376K00000X Licence 342912450110E (NY)

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Registry record

NPI: 1124336821
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2010
Record last updated: 16 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.