Healthcare Provider Details

I. General information

NPI: 1700722402
Provider Name (Legal Business Name): AMANDA JEAN BENZINGER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 GERMANTOWN RD STE 101
DANBURY CT
06810-4087
US

IV. Provider business mailing address

12 DURGY LN
SHERMAN CT
06784-2412
US

V. Phone/Fax

Practice location:
  • Phone: 203-794-5680
  • Fax:
Mailing address:
  • Phone: 203-648-0106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number158483
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: