Healthcare Provider Details

I. General information

NPI: 1689797888
Provider Name (Legal Business Name): JOANN BENN RN, MS, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E. MAIN STREET CANCER CENTER
MT KISCO NY
10549
US

IV. Provider business mailing address

110 S BEDFORD RD CARE MOUNT MEDICAL PC
YORKTOWN HEIGHTS NY
10598-3211
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-1050
  • Fax: 914-242-1516
Mailing address:
  • Phone: 914-245-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number500576
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number333577
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: