Basic Information
| Provider Information | |||||||||
| NPI: | 1760456271 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENEDETTO | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 593 | ||||||||
| Address2: | |||||||||
| City: | CAPE MAY COURT HOUSE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082100593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094632273 | ||||||||
| FaxNumber: | 6097782358 | ||||||||
| Practice Location | |||||||||
| Address1: | 223 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CAPE MAY COURT HOUSE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082102182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094632273 | ||||||||
| FaxNumber: | 6097782358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 02/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 93-00420 | NC | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 34-009971 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 25MB04725200 | NJ | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.