Theresa M Benz, MASTECTOMY FITTER

Individual provider Active NPI Specialist · Springfield, PA

NPI 1194929265 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1194929265
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
1435 (PA)
Practice address
1001 Baltimore Pike
Suite 205
Springfield, PA 19064
Phone
(610) 604-0950
Fax
(610) 604-0970
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1435PAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Theresa M. Benz Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1435 PA Yes

Addresses

Primary practice location

1001 Baltimore Pike
Suite 205
Springfield, PA 19064

Mailing address

1001 Baltimore Pike
Suite 205
Springfield, PA 19064
Phone (610) 604-0950

Other identifiers

IdentifierTypeStateIssuer
232916OtherPABCBS

Other names

  • Terry Benz Professional name

Other providers in Springfield, PA

All providers in Springfield, PA · Specialist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.