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Individual
KEITH DIBENEDETTO
Active
Individual
KEITH DIBENEDETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R210044
MD
363LP2300X
Primary Care Nurse Practitioner
Primary
R210044
MD
Other
Enumeration date
09/18/2018
Last updated
11/14/2024
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