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NPI Code Detail

MEDICARE: BENJAMIN W. CARR PA-C

MEDICARE: BENJAMIN W. CARR PA-C
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
1363AM0700XMedical Physician AssistantMA-001188-LPA

General Provider Information

NPI Number : 1225033756
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN W. CARR PA-C
Provider Business Mailing Address
First Line : PO BOX 13579
Second Line :
City : READING
State : PA
Zip : 19612-3579
Country : US
Telephone Number : 484-628-0799
Fax Number :
Provider Business Practice Location Address
First Line : 420 S 5TH AVE
Second Line :
City : WEST READING
State : PA
Zip : 19611-2143
Country : US
Telephone Number : 484-628-3637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/27/2018

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