Individual
MR. SHANE DANIEL BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 DRUM RD, STATEN ISLAND, NY 10305-5001
(718) 354-4414
Mailing address
215 DRUM RD, STATEN ISLAND, NY 10305-5001
(718) 354-4414
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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