Individual
BENJAMIN JON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1202 DRIVING PARK AVE, NEWARK, NY 14513
(315) 359-2690
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-1304
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
280945
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2012
Last updated
12/16/2022
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