Doctor Name: | JESSICA BENNETT |
NPI Number: | 1811183486 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RTR |
License Number: | CRT14291 |
Business Practice Address: | 17 Warner Hill Rd Ticonderoga, NY - 128833700 |
Business Phone Number: | 3157676721 |
Business Fax Number: | |
Mailing Address: | 17 Warner Hill Rd, TICONDEROGA |
State: | NY |
Postal Code: | 128833700 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/18/2007 |
NPI Last Update Date: | 09/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | CRT14291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |