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General NPI Number Information
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NPI Number | 1982730883
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Entity Type | Individual
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Provider Name | EDNA BENITEZ L.AC.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 103 SAINT MARKS PL APT C
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City | NEW YORK
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State | NY
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Zip | 10009-5156
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Country | US
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Telephone | 917-626-1672
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Fax |
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Provider Business Mailing Address
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Address Line | 411 E 6TH ST APT 18
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City | NEW YORK
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State | NY
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Zip | 10009-6350
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Country | US
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Telephone | 917-626-1672
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 002730
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License Number State | NY
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