Individual
DR. MARYELLEN VERSOZA BENITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
2 MONTAUK HWY, SOUTHAMPTON, NY 11968-4199
(646) 962-9920
Mailing address
2 MONTAUK HWY, SOUTHAMPTON, NY 11968-4199
(646) 962-9920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
263180
NY
Other
Enumeration date
07/23/2007
Last updated
07/16/2023
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