Individual
NILES L BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
133 PARK ST, MALONE, NY 12953-1243
(518) 483-3000
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 449-0513
(315) 445-2936
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
296126
NY
Other
Enumeration date
08/14/2006
Last updated
01/30/2008
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