| David L Benisch, MD PC | |
|
124 Main St Suite 16 Huntington NY 11743-6922 | |
| (631) 423-7000 | |
| (631) 423-9276 |
| Full Name | David L Benisch, MD PC |
|---|---|
| Speciality | Clinic/center |
| Location | 124 Main St, Huntington, New York |
| Authorized Official Name and Position | David Lance Benisch (PRESIDENT) |
| Authorized Official Contact | 6314237000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David L Benisch, MD PC 124 Main St Suite 16 Huntington NY 11743-6922 Ph: (631) 423-7000 | David L Benisch, MD PC 124 Main St Suite 16 Huntington NY 11743-6922 Ph: (631) 423-7000 |
| NPI Number | 1528233889 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 07/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528233889 | NPI | - | NPPES |
| 00425470 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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