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General NPI Number Information
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NPI Number | 1053930842
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Entity Type | Individual
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Provider Name | ROMA COREY BENFANTI PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/11/2020
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 5 COLUMBUS CIR PH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-1412
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Country | US
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Telephone | 646-756-8282
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Fax |
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Provider Business Mailing Address
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Address Line | 400 COLONIAL CENTER PKWY STE 150
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City | LAKE MARY
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State | FL
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Zip | 32746-7684
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Country | US
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Telephone | 407-804-9670
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9116267
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 026758
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License Number State | NY
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