Provider Demographics
NPI:1881873040
Name:BENEDEK, SUSAN MARIE (LAC, MAOM, RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:BENEDEK
Suffix:
Gender:F
Credentials:LAC, MAOM, RN
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Mailing Address - Street 1:74 FAUNCE CORNER RD
Mailing Address - Street 2:SUITE 630
Mailing Address - City:N DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1209
Mailing Address - Country:US
Mailing Address - Phone:508-996-0013
Mailing Address - Fax:508-996-0013
Practice Address - Street 1:74 FAUNCE CORNER RD
Practice Address - Street 2:SUITE 630
Practice Address - City:N DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1209
Practice Address - Country:US
Practice Address - Phone:508-996-0013
Practice Address - Fax:508-996-0013
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2019-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA155916163W00000X
MA222746171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse