Provider Demographics
NPI:1336409119
Name:LIGHTHOUSE PSYCHIATRY, PC
Entity Type:Organization
Organization Name:LIGHTHOUSE PSYCHIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENZIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:215-340-2686
Mailing Address - Street 1:800 W STATE ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2250
Mailing Address - Country:US
Mailing Address - Phone:215-340-2686
Mailing Address - Fax:215-340-4858
Practice Address - Street 1:800 W STATE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2250
Practice Address - Country:US
Practice Address - Phone:215-340-2686
Practice Address - Fax:215-340-4858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty