| Doctor Name: | MS. ENZA MARIA DIBENEDETTO |
| NPI Number: | 1033277496 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.M.A. |
| License Number: | 001504 |
| Business Practice Address: | 104-70 Queens Boulevard Suite 200 Bleuler Psychotherapy Center Forest Hills, NY - 10375 |
| Business Phone Number: | 7182756010 |
| Business Fax Number: | |
| Mailing Address: | 3334 209th St, BAYSIDE |
| State: | NY |
| Postal Code: | 113611462 |
| Phone Number: | 7183525271 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 001504 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |