# JOSEPH D BENEVENTO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1093840944
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 045129 | CT | — |
| 207W00000X | Ophthalmology Physician | 303230 | LA | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | 303230 | LA | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 10/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02726762 | — | MS |
| 01 | — | 036-113758 | STATE LICENSE | IL |
| 01 | — | 045129 | CT MEDICAL LICENSE | CT |
| 05 | — | 2432524 | — | LA |