Provider Demographics
NPI:1952459083
Name:BENE, SCOTT JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JOSEPH
Last Name:BENE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-9367
Mailing Address - Country:US
Mailing Address - Phone:570-459-5090
Mailing Address - Fax:570-459-5090
Practice Address - Street 1:1320 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-9367
Practice Address - Country:US
Practice Address - Phone:570-459-5090
Practice Address - Fax:570-459-5090
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003458L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011520800004Medicaid
PABE555458Medicare ID - Type Unspecified