Individual
DR. MICHAEL JOHN BENYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
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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