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BENARDOT PEDIATRICS PLLC NPI 1730122359


NPI Information

NPI: 1730122359
Provider Name: BENARDOT PEDIATRICS, PLLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 33D1017351

Address:
58 ELM ST
MALONE, NY
ZIP 12953
Phone: (518) 483-5800
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BENARDOT PEDIATRICS, PLLC is a specialist in Malone, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. BENARDOT PEDIATRICS, PLLC NPI is 1730122359. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

58 ELM ST
MALONE, NY
ZIP 12953-507
Phone: (518) 483-5800
Fax: (518) 483-1113

The provider's authorized official is Lisa A Guiffrida .
The authorized official title is Office Manager/billing Specialist and has the following contact phone number (518) 483-5800.

The CLIA number assigned to this NPI record is 33D1017351 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 6/9/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist229747NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102459965MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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