Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 25MA05147800 | NJ |
N | 207RS0012X | Sleep Medicine | 25MA05147800 | NJ |
NPI | 1003817156 |
---|---|
Provider Name | Marc L Benton |
First Address | Madison, NJ 07940 |
Second Address | Madison, NJ 07940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 20/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121696 | CHN INS. (01) | NJ |
222233003 | HORIZON BLUE CROSS (01) | NJ |
222233003004 | CIGNA (01) | NJ |
263944134 | HORIZON BLUE CROSS BLUE SHIELD (01) | NJ |
4109289 | AETNA INS. (01) | NJ |
6752022 | AETNA HMO (01) | NJ |
67F351 | EMPIRE (01) | NJ |
E73397 | (02) | NJ |
ES253 | OXFORD (01) | NJ |