Provider Demographics
NPI:1033291109
Name:BENISCH, BARRY (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:BENISCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WINCHIP RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4142
Mailing Address - Country:US
Mailing Address - Phone:973-568-7754
Mailing Address - Fax:732-499-6122
Practice Address - Street 1:47 WINCHIP RD
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-4142
Practice Address - Country:US
Practice Address - Phone:973-568-7754
Practice Address - Fax:732-499-6122
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NJMA28211207ZB0001X, 207ZD0900X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZN0500X, 207ZP0101X, 207ZP0102X, 207ZP0104X, 207ZP0105X, 207ZC0500X
NJ25MF00036600207ZP0101X
NJ25MA02821100207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No174400000XOther Service ProvidersSpecialist
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0745600Medicaid
NJ400835Medicare ID - Type Unspecified
NJC61480Medicare UPIN