MEDICARE: DR. BENNETT S. SHENKER M.D.

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
1	207Q00000X	Family Medicine Physician	25MA07724800	NJ
2	207Q00000X	Family Medicine Physician	MD427700	PA
3	207V00000X	Obstetrics & Gynecology Physician	MD427700	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1427082429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENNETT S. SHENKER M.D.

Provider Business Mailing Address
First Line	:	1 FEDERAL ST # 200
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1088
Country	:	US
Telephone Number	:	856-356-4924
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 E MAIN ST
Second Line	:
City	:	MAPLE SHADE
State	:	NJ
Zip	:	08052-2679
Country	:	US
Telephone Number	:	856-779-9220
Fax Number	:	856-536-1440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/10/2019

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Directions to “ DR. BENNETT S. SHENKER M.D.” Practice Location

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