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General NPI Number Information
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NPI Number | 1942322300
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Entity Type | Individual
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Provider Name | JOSE L BENITEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 528 E 29TH ST
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City | PATERSON
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State | NJ
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Zip | 07504-1814
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Country | US
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Telephone | 973-278-4650
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Fax |
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Provider Business Mailing Address
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Address Line | 346 N FARVIEW AVE
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City | PARAMUS
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State | NJ
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Zip | 07652-4631
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Country | US
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Telephone | 201-265-0098
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA02802300
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License Number State | NJ
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