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General NPI Number Information
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NPI Number | 1326536285
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Entity Type | Individual
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Provider Name | PETER ALLERTON BENEDICT MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1 TELEPORT DR STE 200
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City | STATEN ISLAND
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State | NY
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Zip | 10311-1000
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Country | US
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Telephone | 718-370-0072
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Fax | 718-370-6733
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Provider Business Mailing Address
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Address Line | 660 WHITE PLAINS RD STE 400
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City | TARRYTOWN
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State | NY
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Zip | 10591-5107
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Country | US
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Telephone | 914-984-2546
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 330719
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD480474
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License Number State | PA
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