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Individual
TOM BENOLERAO
Active
Individual
TOM BENOLERAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10586212-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02566383
—
NY
01
—
1000043901
AFFINITY
NY
01
—
173774P
HIP
NY
01
—
Q13E71
EMPIRE BLUE CROSS BLUE SHIELD
NY
Enumeration date
11/02/2006
Last updated
12/20/2023
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