Healthcare Provider Details

I. General information

NPI: 1528962826
Provider Name (Legal Business Name): BENJAMIN MICHAEL WHITMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 W 25TH ST
ERIE PA
16544-0002
US

IV. Provider business mailing address

2194 5TH AVE
LAKEWOOD NY
14750-9711
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP460775
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: