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General NPI Number Information
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NPI Number | 1104424118
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Entity Type | Individual
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Provider Name | TAYLOR BENEVENTO MSPT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 77 3RD ST
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City | STAMFORD
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State | CT
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Zip | 06905-4722
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Country | US
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Telephone | 203-204-3092
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Fax |
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Provider Business Mailing Address
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Address Line | 290 WEED ST
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City | NEW CANAAN
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State | CT
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Zip | 06840-6118
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Country | US
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Telephone | 917-579-4423
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12605
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License Number State | CT
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