Individual
DR. BENOIT D TANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
622 HEBRON AVE, GLASTONBURY, CT 06033-2421
(860) 659-8904
Mailing address
622 HEBRON AVE, GLASTONBURY, CT 06033-2421
(860) 659-8904
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
M4963
TX
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
PT11501
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M4963
TEXAS MEDICAL LICENSE
—
Enumeration date
12/04/2006
Last updated
10/14/2024
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