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NPI Code Detail

MEDICARE: JAMES BENWARE LPN

MEDICARE:   JAMES  BENWARE  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse284948NY

General Provider Information

NPI Number : 1164964185
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES BENWARE LPN
Provider Business Mailing Address
First Line : 130 MC GOWAN RD
Second Line :
City : NORTH BANGOR
State : NY
Zip : 12966-1810
Country : US
Telephone Number : 518-353-0323
Fax Number :
Provider Business Practice Location Address
First Line : 130 MC GOWAN RD
Second Line :
City : NORTH BANGOR
State : NY
Zip : 12966-1810
Country : US
Telephone Number : 518-353-0323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2016
Last Update Date : 11/08/2016

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Directions to “ JAMES BENWARE LPN” Practice Location

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