Kenneth Benfante, | |
2156 Victory Blvd, Staten Island, NY 10314-6626 | |
(201) 638-2679 | |
Not Available |
Full Name | Kenneth Benfante |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 2156 Victory Blvd, Staten Island, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396496287 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | X013482-01 (New York) | Primary |
Provider Name | New York Spinal Correction Chiropractic Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1790439628 PECOS PAC ID: 9436537354 Enrollment ID: O20220606002582 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Benfante, 2156 Victory Blvd, Staten Island, NY 10314-6626 Ph: (201) 638-2679 | Kenneth Benfante, 2156 Victory Blvd, Staten Island, NY 10314-6626 Ph: (201) 638-2679 |
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