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NPI Code Detail

MEDICARE: HARVEY BENNETT MD

MEDICARE: HARVEY BENNETT MD
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
12084N0402XNeurology with Special Qualifications in Child Neurology Physician25MA07909100NJ
22084N0402XNeurology with Special Qualifications in Child Neurology Physician73087CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285609495
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARVEY BENNETT MD
Provider Business Mailing Address
First Line : PO BOX 23831
Second Line :
City : NEWARK
State : NJ
Zip : 07189-0001
Country : US
Telephone Number : 973-971-7184
Fax Number : 973-290-8349
Provider Business Practice Location Address
First Line : 1 PARK ST
Second Line :
City : NEW HAVEN
State : CT
Zip : 06504-8901
Country : US
Telephone Number : 203-785-4081
Fax Number : 203-737-7635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 02/13/2023

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