Organization
PHILIP J. BENYO, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP J. BENYO M.D. (PHYSICIAN)
(570) 788-6363
Entity
Organization
Contact information
Practice address
144 S OLD TURNPIKE RD, DRUMS, PA 18222-1720
(570) 788-6363
Mailing address
144 S OLD TURNPIKE RD, PO BOX 395, DRUMS, PA 18222-1720
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD022634E
PA
363AM0700X
Medical Physician Assistant
MA051116
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104097
MEDICARE GROUP #
PA
01
—
104101VRM
MEDICARE PHYSICIAN ASST.
PA
01
—
400852VRM
MEDICARE DR.'S INDIVIDUAL
PA
Enumeration date
09/16/2006
Last updated
07/27/2007
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