MEDICARE: DR. AUGUSTUS BENTSI-BARNES M.D.

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	207V00000X	Obstetrics & Gynecology Physician	193600	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336240795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUGUSTUS BENTSI-BARNES M.D.

Provider Business Mailing Address
First Line	:	368 BROADWAY STE 105
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-5160
Country	:	US
Telephone Number	:	845-334-8635
Fax Number	:	845-334-8637

Provider Business Practice Location Address
First Line	:	368 BROADWAY STE 105
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-5160
Country	:	US
Telephone Number	:	845-334-8635
Fax Number	:	845-334-8637

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	11/09/2021

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