MEDICARE: BENEDETTO AND ASSOCIATES

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	1041C0700X	Clinical Social Worker		OH

General Provider Information

NPI Number	:	1720269830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENEDETTO AND ASSOCIATES

Provider Business Mailing Address
First Line	:	8227 BRECKSVILLE RD
Second Line	:	104
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-1370
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20033 DETROIT RD
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-2400
Country	:	US
Telephone Number	:	440-526-0468
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGE
Name	:	DOREEN BENEDETTO
Credential	:
Telephone Number	:	440-526-0468

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/19/2007

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