Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 76228 | MA |
Y | 208600000X | Surgeon | 76228 | MA |
N | 2082S0105X | Plastic Hand Surgeon | 76228 | MA |
N | 2086S0105X | Surgery of the Hand | 76228 | MA |
NPI | 1144391079 |
---|---|
Provider Name | Dr. Peter Edward Bentivegna |
First Address | West Yarmouth, MA 02673-2582 |
Second Address | West Yarmouth, MA 02673-2582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 11/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
737491 | TUFTS HEALTH PLANS (01) | MA |
AA58432 | HARVARD PILGRIM (01) | MA |
F00830 | (02) | MA |
J12891 | BLUE CROSS BLUE SHIELD (01) | MA |