Benjamin, Marc Andrew

Benjamin, Marc Andrew is an individual health care provider with primary practice located at 80 Seymour Street Hartford Hospital Surgery Dept, Hartford CT 06102-5037. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Benjamin, Marc Andrew can be contacted via phone (860) 972-4670.

Contact Information

Primary practice address
80 Seymour Street Hartford Hospital Surgery Dept Hartford CT 06102-5037
Phone: (860) 972-4670
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 000991 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 000991 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 000991 Connecticut

Profile Details

NPI number 1639166911
LBN Legal business name Benjamin, Marc Andrew
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated May 27th, 2014 - about 11 years 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 1639166911 NPPES
Connecticut MEDICAID 003009917

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