Provider Demographics
NPI:1801058839
Name:BENSEN-KENNEDY, DEBRA MARIE (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:BENSEN-KENNEDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:MARIE
Other - Last Name:BENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:80 HORSESHOE PT
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4659
Mailing Address - Country:US
Mailing Address - Phone:610-983-9548
Mailing Address - Fax:
Practice Address - Street 1:80 HORSESHOE PT
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4659
Practice Address - Country:US
Practice Address - Phone:610-983-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428167207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology