Provider Demographics
NPI:1376141069
Name:BENJAMIN P LICHTENFELS DO PC
Entity Type:Organization
Organization Name:BENJAMIN P LICHTENFELS DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LICHTENFELS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-886-6000
Mailing Address - Street 1:2358 S COUNTY TRL
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1583
Mailing Address - Country:US
Mailing Address - Phone:401-886-6000
Mailing Address - Fax:401-886-6002
Practice Address - Street 1:2358 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1583
Practice Address - Country:US
Practice Address - Phone:401-886-6000
Practice Address - Fax:401-886-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty