Doctor Name: | SUSAN E BENN |
NPI Number: | 1417990839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | 001700 |
Business Practice Address: | 73 Cedar St New Britain, CT - 060521390 |
Business Phone Number: | 8608324666 |
Business Fax Number: | 8603484931 |
Mailing Address: | 73 Cedar St, NEW BRITAIN |
State: | CT |
Postal Code: | 060521390 |
Phone Number: | 8608324666 |
Fax Number: | 8603484931 |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 07/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 001700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |