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Individual

DAVID J DIBENEDETTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
85 1ST AVE, WALTHAM, MA 02451-1105
(781) 894-5522
Mailing address
85 1ST AVE, WALTHAM, MA 02451-1105
(781) 894-5522

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
150895
MA
208VP0014X
Interventional Pain Medicine Physician
Primary
150895
MA

Other

Enumeration date
07/31/2006
Last updated
02/23/2017
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