Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Andrew Shaw Benotakeia, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1568112654

Andrew Shaw Benotakeia, MD is a Student in an Organized Health Care Education/Training Program in Hackensack, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone: (551) 996-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (NJ)

Record details

NPI number1568112654
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 24, 2022
Last updated in NPPESMarch 24, 2022
Certification dateMarch 24, 2022

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