Basic Information
Provider Information
NPI: 1447645437
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NJENGA
FirstName: BENSON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9 INDUSTRIAL RD STE 5
Address2:  
City: MILFORD
State: MA
PostalCode: 017573736
CountryCode: US
TelephoneNumber: 5084731480
FaxNumber: 5084731210
Practice Location
Address1: 14 PROSPECT ST
Address2:  
City: MILFORD
State: MA
PostalCode: 017573003
CountryCode: US
TelephoneNumber: 5084731190
FaxNumber: 5084825416
Other Information
ProviderEnumerationDate: 04/06/2015
LastUpdateDate: 07/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X277443MAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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