Individual
EDWARD HARRIS BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 ELM ST, SUITE 205, ENFIELD, CT 06082-3712
(860) 741-2531
(860) 745-7587
Mailing address
115 ELM ST, SUITE 205, ENFIELD, CT 06082-3712
(860) 741-2531
(860) 745-7587
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
021127
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000P00382
HEALTH NET
—
01
—
0044560
AETNA
—
01
—
010021127CT01
BLUE CROSS
—
01
—
052513
CONNECTICARE
—
01
—
061044668 0001
CIGNA
—
05
—
1211275
—
CT
01
—
P857762
OXFORD
—
Enumeration date
01/19/2007
Last updated
07/08/2007
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