Provider Demographics
NPI:1922359827
Name:BENOIT, MARIE ANDREE (NP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:ANDREE
Last Name:BENOIT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6508
Mailing Address - Country:US
Mailing Address - Phone:718-975-2270
Mailing Address - Fax:718-975-2271
Practice Address - Street 1:1349 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-3618
Practice Address - Country:US
Practice Address - Phone:718-975-2270
Practice Address - Fax:718-975-2271
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY463877163W00000X
NYF335762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse