Individual
THOMAS EDWARD BENIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5775 WAYZATA BLVD STE 200, MINNEAPOLIS, MN 55416-1227
(952) 525-4511
(952) 525-1560
Mailing address
5775 WAYZATA BLVD STE 200, MINNEAPOLIS, MN 55416-1227
(952) 525-4511
(952) 525-1560
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP0706
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01014969
PREFERRED ONE
—
05
—
10088
—
ND
01
—
15-82098
MEDICA
—
01
—
71318BE
BLUE CROSS BLUE SHIELD
—
01
—
765445
AMERICAS PPO
—
01
—
A015
TRIWEST
—
01
—
HP37238
HEALTHPARTNERS
—
Enumeration date
08/01/2006
Last updated
07/08/2007
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