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General NPI Number Information
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NPI Number | 1487983540
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Entity Type | Individual
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Provider Name | BENNET KOKU TOGBE MB CHB
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Gender | Male
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 99 EAST STATE STREET MAB SUITE 107
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-0010
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Country | US
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Telephone | 518-773-5687
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Fax | 518-773-5232
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Provider Business Mailing Address
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Address Line | 1600 N MAIN AVE
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City | LOVINGTON
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State | NM
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Zip | 88260-2813
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Country | US
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Telephone | 575-396-6611
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 268700
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD445883
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD2022-1343
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License Number State | NM
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