Bennison, William M

Bennison, William M is an sole proprietor health care provider with primary practice located at 1 High Path Hope House, Port Jefferson NY 11777-1276. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bennison, William M can be contacted via phone (631) 928-9112.

Contact Information

Primary practice address
1 High Path Hope House Port Jefferson NY 11777-1276
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 006877 New York

Profile Details

NPI number 1962489153
LBN Legal business name Bennison, William M
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2005
Last updated Apr 19th, 2010 - about 14 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 1962489153 NPPES
New York MEDICAID 00696231

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