MEDICARE: VERONICA BENTON LPN

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	164W00000X	Licensed Practical Nurse	287149-1	NY
2	374700000X	Technician		NY
3	174400000X	Specialist		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	:	1831319110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA BENTON LPN

Provider Business Mailing Address
First Line	:	1232 METCALF AVE APT 6H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2898
Country	:	US
Telephone Number	:	347-259-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232 METCALF AVE APT 6H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2898
Country	:	US
Telephone Number	:	347-259-4900
Fax Number	:

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

Provider Enumeration Date	:	04/27/2007
Last Update Date	:	08/06/2023

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