Healthcare Provider Details

I. General information

NPI: 1992476493
Provider Name (Legal Business Name): MORGAN ELIZABETH BENEDETTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6723 TOWPATH RD
EAST SYRACUSE NY
13057-9506
US

IV. Provider business mailing address

507 S BAY RD
SYRACUSE NY
13212-3626
US

V. Phone/Fax

Practice location:
  • Phone: 315-425-1004
  • Fax:
Mailing address:
  • Phone: 315-409-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number010860
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: