MEDICARE: BENJAMIN ESGRO

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	133V00000X	Registered Dietitian	ND6559	FL

General Provider Information

NPI Number	:	1962368456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN ESGRO

Provider Business Mailing Address
First Line	:	552 N WEBSTER AVE
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18510-2215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	552 N WEBSTER AVE
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18510-2215
Country	:	US
Telephone Number	:	570-594-6167
Fax Number	:

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

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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Directions to “ BENJAMIN ESGRO ” Practice Location

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