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NPI Code Detail

MEDICARE: AMIT SUDHAKAR BENEDICT

MEDICARE: AMIT SUDHAKAR BENEDICT
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner406657NY

General Provider Information

NPI Number : 1952114498
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIT SUDHAKAR BENEDICT
Provider Business Mailing Address
First Line : 611 W MAIN ST
Second Line :
City : WATERTOWN
State : NY
Zip : 13601-1337
Country : US
Telephone Number : 315-965-4832
Fax Number : 315-777-8859
Provider Business Practice Location Address
First Line : 611 W MAIN ST
Second Line :
City : WATERTOWN
State : NY
Zip : 13601-1337
Country : US
Telephone Number : 315-965-4832
Fax Number : 315-777-8859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2025
Last Update Date : 01/21/2026

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