Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS014188 | PA |
NPI | 1003024936 |
---|---|
Provider Name | Joseph Eli Benaknin |
First Address | Harrisburg, PA 17104-1621 |
Second Address | Harrisburg, PA 17101-2010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 30/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1020762700002 | (05) | PA |
1020762700003 | (05) | PA |
1572181 | GATEWAY (01) | |
2061044 | HIGHMARK BLUE SHIELD (01) | |
244925 | UNISON (01) |