Provider Demographics
NPI:1811525090
Name:BENO, BRIAN J (MPT, CERT MDT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:BENO
Suffix:
Gender:M
Credentials:MPT, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2303
Mailing Address - Country:US
Mailing Address - Phone:267-626-7146
Mailing Address - Fax:
Practice Address - Street 1:137 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2303
Practice Address - Country:US
Practice Address - Phone:267-626-7146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPTO11899L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist