Individual
MRS. DIANA I. BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 SHERIDAN AVE, BRONX, NY 10456-6100
(917) 792-7600
(917) 792-7603
Mailing address
21930 STEWART RD, QUEENS VILLAGE, NY 11427-1110
(718) 464-5364
(718) 464-5364
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0101-0407-7314-645
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101-0407-7314-645
PHARMACY TECHNICIAN
NY
Enumeration date
11/21/2005
Last updated
05/03/2012
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