Provider Demographics
NPI:1831303718
Name:BENETOS, MARIA F (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:F
Last Name:BENETOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BROOKSITE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3492
Mailing Address - Country:US
Mailing Address - Phone:631-265-0909
Mailing Address - Fax:631-265-0757
Practice Address - Street 1:2 BROOKSITE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3492
Practice Address - Country:US
Practice Address - Phone:631-265-0909
Practice Address - Fax:631-265-0757
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250970-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry