Provider Demographics
NPI:1679705834
Name:DICHIARA, BENJAMIN J (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:J
Last Name:DICHIARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 WHITETAIL DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-1996
Mailing Address - Country:US
Mailing Address - Phone:504-321-0411
Mailing Address - Fax:504-321-0412
Practice Address - Street 1:200 PARIS AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3018
Practice Address - Country:US
Practice Address - Phone:504-321-0411
Practice Address - Fax:504-321-0412
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1518111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner