Provider Demographics
NPI:1689797888
Name:BENN, JOANN (RN, MS, FNP-C)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:BENN
Suffix:
Gender:F
Credentials:RN, MS, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CARE MOUNT MEDICAL PC
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-3211
Mailing Address - Country:US
Mailing Address - Phone:914-245-0918
Mailing Address - Fax:
Practice Address - Street 1:400 E. MAIN STREET
Practice Address - Street 2:CANCER CENTER
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY500576163WX0200X
NY333577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02458120Medicaid
NYA400053207Medicare PIN