Provider Demographics
NPI:1659457190
Name:BENENATI, JAMES G (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:BENENATI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 JERUSALEM AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1606
Mailing Address - Country:US
Mailing Address - Phone:516-679-2111
Mailing Address - Fax:516-676-2113
Practice Address - Street 1:3807 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1606
Practice Address - Country:US
Practice Address - Phone:516-679-2111
Practice Address - Fax:516-676-2113
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP747336OtherOXFORD
NY24181OtherEMPIRE BC BS
NY127282OtherAETNA
NY801362OtherMPN
NY92440OtherGHI
NY127282OtherAETNA
NY24181OtherEMPIRE BC BS