Benenson, Amy Rose

Benenson, Amy Rose is an individual health care provider with primary practice located at 289 Windham Rd , Willimantic CT 06226-3528. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Benenson, Amy Rose can be contacted via phone (860) 343-0302.

Contact Information

Primary practice address
289 Windham Rd Willimantic CT 06226-3528
Phone: (860) 343-0302
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X PA01468 Rhode Island
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5717 Connecticut

Profile Details

NPI number 1427788009
LBN Legal business name Benenson, Amy Rose
Credentials MSPAS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2022
Last updated Jan 4th, 2024 - about 11 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427788009 NPPES
Rhode Island MEDICAID PA01468

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