Individual
MARC ANDREW BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL SURGERY DEPT, HARTFORD, CT 06102-5037
(860) 972-4670
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 972-9047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000991
CT
363AM0700X
Medical Physician Assistant
000991
CT
363AS0400X
Surgical Physician Assistant
Primary
000991
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003009917
—
CT
Enumeration date
10/03/2005
Last updated
05/27/2014
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