Provider Demographics
NPI:1851912299
Name:BENCIVENGA, ERICA JANE (FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:JANE
Last Name:BENCIVENGA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:J
Other - Last Name:SCHRUMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5193
Mailing Address - Fax:
Practice Address - Street 1:5 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2013
Practice Address - Country:US
Practice Address - Phone:860-224-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9475363LF0000X, 363LF0000X
NC5013149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily