Individual
BRACA BENIZRY CANTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9669 E 146TH ST STE 250A, NOBLESVILLE, IN 46060-5006
(317) 621-4657
Mailing address
1400 N RITTER AVE STE 231, INDIANAPOLIS, IN 46219-3099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01078170A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01078170A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017550
—
IN
Enumeration date
04/07/2014
Last updated
10/23/2024
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