Provider Demographics
NPI:1114957560
Name:BENTIVEGNA, JOSEPH FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:BENTIVEGNA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:541 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1805
Mailing Address - Country:US
Mailing Address - Phone:860-721-8800
Mailing Address - Fax:860-721-1694
Practice Address - Street 1:541 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1805
Practice Address - Country:US
Practice Address - Phone:860-721-8800
Practice Address - Fax:860-721-1694
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT028097207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology