Provider Demographics
NPI:1760456271
Name:BENEDETTO, JOSEPH CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHARLES
Last Name:BENEDETTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-463-2273
Mailing Address - Fax:609-778-2358
Practice Address - Street 1:223 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2182
Practice Address - Country:US
Practice Address - Phone:609-463-2273
Practice Address - Fax:609-778-2358
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93-00420208600000X
OH34-009971208600000X
NJ25MB04725200208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9296871Medicare UPIN