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General NPI Number Information
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NPI Number | 1154351724
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Entity Type | Individual
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Provider Name | JODI A BENETT D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 1930 STATE HWY 70 E STE S93 EXECUTIVE MEWS
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City | CHERRY HILL
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State | NJ
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Zip | 08003-4208
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Country | US
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Telephone | 856-424-8091
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Fax | 856-424-0704
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Provider Business Mailing Address
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Address Line | 1930 ROUTE 70 EAST SUITE S-93
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City | CHERRY HILL
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State | NJ
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Zip | 08003-4208
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Country | US
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Telephone | 856-424-8091
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Fax | 856-424-0704
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MB05291400
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License Number State | NJ
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