Fan, Benjamin

Fan, Benjamin is an sole proprietor health care provider with primary practice located at 1719 Main Street , Lake Como NJ 07719. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Fan, Benjamin can be contacted via phone (732) 894-9200.

Contact Information

Primary practice address
1719 Main Street Lake Como NJ 07719
Phone: (732) 894-9200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 40QA01655100 New Jersey

Profile Details

NPI number 1932561875
LBN Legal business name Fan, Benjamin
Credentials PT, DPT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 21st, 2016
Last updated Mar 21st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932561875 NPPES
New Jersey Other 40QA01655100 LICENSE#: 40QA01655100

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