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General NPI Number Information
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NPI Number | 1043697709
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Entity Type | Individual
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Provider Name | BENJAMIN JOHN DORFMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 280 SOUTH MAIN STREET SUITE 102
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City | CHESHIRE
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State | CT
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Zip | 06410
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Country | US
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Telephone | 860-870-6385
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Fax | 203-250-0191
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Provider Business Mailing Address
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Address Line | 280 SOUTH MAIN STREET SUITE 102
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City | CHESHIRE
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State | CT
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Zip | 06410
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Country | US
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Telephone | 212-241-5607
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Fax | 212-241-3656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 299901
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 69168
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License Number State | CT
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