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General NPI Number Information
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NPI Number | 1326764044
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Entity Type | Organization
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Legal Business Name | BENESRT3
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | C/O 8 LOCUST STREET 1R
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City | CARTERET
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State | NJ
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Zip | 07008
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Country | US
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Telephone | 732-874-0156
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Fax |
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Provider Business Mailing Address
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Address Line | 19 GRAND AVE # 1
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City | NEWARK
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State | NJ
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Zip | 07106-1223
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Country | US
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Telephone | 732-874-0156
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Fax |
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Authorized Official
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Title or Position | DR. DO D. PSC
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Name | NANTUME-JANET: KABANDA,BENEFICIARY
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Credential | DR. DO D. PSC
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Telephone | 732-874-0156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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