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Individual
STANFORD BENNETT
Active
Individual
STANFORD BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5390584
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093159
GHI-HMO
—
01
—
050922000003
FIDELIS CARE OF NY
—
01
—
10102747
CDPHP
—
01
—
1092475
AETNA-HMO
—
01
—
129SD1
EMPIRE BC-BS
—
01
—
2545905
UNITED HEALTHCARE
—
01
—
388166
MVP HEALTHPLAN
—
01
—
3C5202
HEALTHNET-GROUP PIN
—
01
—
5294204
CIGNA PROVIDER ID
—
01
—
7530743
AETNA-PPO
—
01
—
GHI -PPO
2589257
—
01
—
P3609126
OXFORD HEALTH PLAN
—
Enumeration date
08/30/2005
Last updated
09/29/2011
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