Individual
JOSEPH D BENEVENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3995
(504) 842-5970
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
045129
CT
207W00000X
Ophthalmology Physician
303230
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
303230
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02726762
—
MS
01
—
036-113758
STATE LICENSE
IL
01
—
045129
CT MEDICAL LICENSE
CT
05
—
2432524
—
LA
Enumeration date
02/22/2007
Last updated
10/06/2020
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