Individual
JOANNE LEE BENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
113 VAN SCOY RD, POUGHQUAG, NY 12570-5236
(845) 418-0116
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
027048
NY
Other
Enumeration date
06/22/2021
Last updated
01/21/2022
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