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General NPI Number Information
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NPI Number | 1720085376
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Entity Type | Individual
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Provider Name | BARRY J BENJAMIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 1 LYONS ST
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City | DEDHAM
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State | MA
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Zip | 02026-5599
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Country | US
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Telephone | 617-421-5984
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Fax | 781-278-5667
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Provider Business Mailing Address
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Address Line | 1 LYONS ST
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City | DEDHAM
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State | MA
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Zip | 02026-5599
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Country | US
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Telephone | 617-421-5984
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Fax | 781-278-5667
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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 | 35621
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License Number State | MA
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