Provider Demographics
NPI:1801296843
Name:STEPHEN S. BENHAM,MDPC
Entity type:Organization
Organization Name:STEPHEN S. BENHAM,MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-563-7477
Mailing Address - Street 1:41A DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-1336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41A DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1336
Practice Address - Country:US
Practice Address - Phone:607-563-7477
Practice Address - Fax:607-563-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty