Individual
BENEDICT FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 CELLINI PL STE 102, WEST HAVEN, CT 06516-1666
(203) 932-6481
(203) 889-4953
Mailing address
1 CELLINI PL STE 102, WEST HAVEN, CT 06516-1666
(203) 932-6481
(203) 889-4953
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
016636
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001166362
—
CT
01
—
010016636CT02
ANTHEM BLUE SHIELD
CT
01
—
016636
CONNECTICARE
CT
01
—
110194408
RAILROAD MEDICARE
CT
01
—
2033800
AETNA
CT
01
—
P571228
OXFORD
CT
Enumeration date
06/27/2005
Last updated
02/28/2023
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