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Individual

DR. JOHN D. BENNETT JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2 PALISADES DR, ALBANY, NY 12205-1438
(518) 458-2000
(518) 458-1524
Mailing address
4 ATRIUM DR, ATTN: TAMMY M. BUTTON, ALBANY, NY 12205-1441
(518) 435-2740
(518) 458-2610

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
138908
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00915233
NY
Enumeration date
07/11/2005
Last updated
07/08/2007
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