Individual
ABILA BENAZEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
103 MYRON ST, WEST SPRINGFIELD, MA 01089-1598
(413) 592-1980
(413) 439-0100
Mailing address
9 VISTA AVE, SALEM, MA 01970-1027
(781) 521-0302
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
RN279930
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
279930
MA
Other
Enumeration date
10/31/2013
Last updated
05/02/2023
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