Individual
DR. MICHAEL JOHN BENYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 887-3236
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000948
PA
152W00000X
Optometrist
TUV004754-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011014560001
—
PA
05
—
01054920
—
NY
01
—
410043463
RR MEDICARE PIN
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039785
MEDICARE GROUP
PA
01
—
P00324442
RR MEDICARE PIN
NY
Enumeration date
03/14/2006
Last updated
03/05/2021
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