MEDICARE: MS. LAURA M BENINCASA RPH

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	183500000X	Pharmacist	040276	NY

General Provider Information

NPI Number	:	1821085341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA M BENINCASA RPH

Provider Business Mailing Address
First Line	:	683 ANDERSON AVE
Second Line	:
City	:	FRANKLIN SQUARE
State	:	NY
Zip	:	11010-3201
Country	:	US
Telephone Number	:	516-489-2940
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 MEACHAM AVE
Second Line	:
City	:	ELMONT
State	:	NY
Zip	:	11003-2630
Country	:	US
Telephone Number	:	516-354-2950
Fax Number	:	516-354-3375

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	07/08/2007

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