Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 16127 | MA |
Y | 213EG0000X | General Practice | 16127 | MA |
NPI | 1003020793 |
---|---|
Provider Name | Joseph P Beninato |
First Address | Methuen, MA 01844 |
Second Address | Methuen, MA 01844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0268569 | (05) | MA |