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NPI Code Detail

MEDICARE: BENJAMIN JOHN DE NOOY MA, NCC

MEDICARE:   BENJAMIN JOHN DE NOOY  MA, NCC
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
1390200000XStudent in an Organized Health Care Education/Training Program103248CO

General Provider Information

NPI Number : 1881946812
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN JOHN DE NOOY MA, NCC
Provider Business Mailing Address
First Line : 2295 S BIRCH ST
Second Line :
City : DENVER
State : CO
Zip : 80222-5019
Country : US
Telephone Number : 641-780-5030
Fax Number :
Provider Business Practice Location Address
First Line : 2295 S BIRCH ST
Second Line :
City : DENVER
State : CO
Zip : 80222-5019
Country : US
Telephone Number : 641-780-5030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2012
Last Update Date : 10/15/2012

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Directions to “ BENJAMIN JOHN DE NOOY MA, NCC” Practice Location

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