Provider Demographics
NPI:1649266123
Name:BENEDETTO-ANZAI, MARIA T (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:BENEDETTO-ANZAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 37TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3256
Mailing Address - Country:US
Mailing Address - Phone:212-263-8682
Mailing Address - Fax:
Practice Address - Street 1:345 E 37TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3256
Practice Address - Country:US
Practice Address - Phone:212-263-8682
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211015207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53Z171Medicare ID - Type Unspecified
NYH05045Medicare UPIN