Doctor Name: | LAURA ANN BENTIVENGA |
NPI Number: | 1255593588 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F335563 |
Business Practice Address: | 1985 Crompond Rd Cortlandt Manor, NY - 105674146 |
Business Phone Number: | 9147360703 |
Business Fax Number: | 9147369234 |
Mailing Address: | 1985 Crompond Rd, CORTLANDT MANOR |
State: | NY |
Postal Code: | 105674146 |
Phone Number: | 9147360703 |
Fax Number: | 9147369234 |
NPI Enumeration Date: | 06/27/2008 |
NPI Last Update Date: | 06/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F335563 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |