MEDICARE: MARIA BENZONI M. ED., LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	51207	NY
2	1041C0700X	Clinical Social Worker	51207

General Provider Information

NPI Number	:	1144467093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA BENZONI M. ED., LMSW

Provider Business Mailing Address
First Line	:	PO BOX 31
Second Line	:
City	:	GENESEO
State	:	NY
Zip	:	14454-0031
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5739 BARBER HILL RD.
Second Line	:
City	:	GENESEO
State	:	NY
Zip	:	14454-0031
Country	:	US
Telephone Number	:	585-243-5232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	01/14/2009

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