Provider Demographics
NPI:1023473683
Name:BENSHIDAH, ELENORA
Entity type:Individual
Prefix:
First Name:ELENORA
Middle Name:
Last Name:BENSHIDAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-2424
Mailing Address - Country:US
Mailing Address - Phone:315-450-1669
Mailing Address - Fax:315-927-4111
Practice Address - Street 1:4600 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-2424
Practice Address - Country:US
Practice Address - Phone:315-450-1669
Practice Address - Fax:315-299-7769
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY636967163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse