Provider Demographics
NPI:1851711329
Name:BENET, RUTH G (DO)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:G
Last Name:BENET
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 1:330 POMFRET ST
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-1854
Mailing Address - Country:US
Mailing Address - Phone:860-928-2736
Mailing Address - Fax:860-928-6367
Practice Address - Street 1:330 POMFRET ST
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1854
Practice Address - Country:US
Practice Address - Phone:860-928-2736
Practice Address - Fax:860-928-6367
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270617207Q00000X
CT11461306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine