Provider Demographics
NPI:1144400060
Name:BENSHIMOL, LUANNE (NP)
Entity Type:Individual
Prefix:MS
First Name:LUANNE
Middle Name:
Last Name:BENSHIMOL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 FLANDERS RD
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-1264
Mailing Address - Country:US
Mailing Address - Phone:860-739-5426
Mailing Address - Fax:860-739-0063
Practice Address - Street 1:248 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-1264
Practice Address - Country:US
Practice Address - Phone:860-739-5426
Practice Address - Fax:860-739-0063
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2016-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000323363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care