Provider Information for 1629892062
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LINDA J BENVENUTI
Sex: Female
NPI: 1629892062
Last Updated: 2024-11-12
Certification Date: 2024-11-12
Certification Date: 2024-11-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629892062 | ||||||||
| Enumeration Date | 2024-11-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 27 SHEPHERD DR WAKEFIELD, RI 02879-5730 United States Phone: 401-477-0700 | Fax:401-789-7259 | ||||||||
| Primary Practice Address | 27 SHEPHERD DR WAKEFIELD, RI 02879-5730 United States Phone: 401-477-0700 | Fax:401-789-7259 | ||||||||
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