Provider Demographics
NPI:1922658517
Name:BENOIT, JAZMIN LYN
Entity Type:Individual
Prefix:
First Name:JAZMIN
Middle Name:LYN
Last Name:BENOIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MUSTARD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-6980
Mailing Address - Country:US
Mailing Address - Phone:585-353-6561
Mailing Address - Fax:
Practice Address - Street 1:1 MUSTARD ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-6980
Practice Address - Country:US
Practice Address - Phone:585-353-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist