Individual
ANDREA BENACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, 3RD FL OUT PATIENT BLDG, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
P.O BOX 8277783, PHILADELPHIA, PA 19185-7783
(215) 707-3326
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD027995E
PA
Other
Enumeration date
10/17/2005
Last updated
01/20/2010
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