Provider Demographics
NPI:1689940413
Name:BENIGNO, JEANNETTE SUSAN (MSN)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:SUSAN
Last Name:BENIGNO
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7270 EDGEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-9712
Mailing Address - Country:US
Mailing Address - Phone:716-693-8215
Mailing Address - Fax:
Practice Address - Street 1:346 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1804
Practice Address - Country:US
Practice Address - Phone:716-856-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309014-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health