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General NPI Number Information
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NPI Number | 1417274408
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Entity Type | Individual
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Provider Name | LUKE JOHN BENVENUTO MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 630 WEST 168TH STREET
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-342-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 630 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 212-342-5155
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 269140
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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