Provider Demographics
NPI:1164405353
Name:BENE, NATALIE IVANA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:IVANA
Last Name:BENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PINE GROVE CMNS
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5161
Mailing Address - Country:US
Mailing Address - Phone:717-755-4422
Mailing Address - Fax:717-755-2390
Practice Address - Street 1:400 PINE GROVE CMNS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5161
Practice Address - Country:US
Practice Address - Phone:717-755-4422
Practice Address - Fax:717-755-2390
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423402207N00000X, 207ND0101X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI01737Medicare UPIN
PA076834Medicare ID - Type Unspecified