Provider Demographics
NPI:1740599984
Name:M BENIT MD INC
Entity Type:Organization
Organization Name:M BENIT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BENIT
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:440-323-4155
Mailing Address - Street 1:661 E RIVER ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5901
Mailing Address - Country:US
Mailing Address - Phone:440-323-4155
Mailing Address - Fax:440-323-6860
Practice Address - Street 1:661 E RIVER ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5901
Practice Address - Country:US
Practice Address - Phone:440-323-4155
Practice Address - Fax:440-323-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036508174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0227687Medicaid
OHA74657Medicare UPIN
OH0227687Medicaid