Individual
COLLEEN ELIZABETH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, 9NW, ROOM 55, PHILADELPHIA, PA 19104-4319
(215) 590-1220
Mailing address
3401 CIVIC CENTER BLVD, 9NW, ROOM 55, PHILADELPHIA, PA 19104-4319
(215) 590-1220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MT205872
PA
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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