Kaitlyn Louise Benedetto, PN

Individual provider Active NPI Licensed Practical Nurse · Rome, NY

NPI 1780145656 · NPPES record last updated Dec 10, 2021

Key facts

NPI
1780145656
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
334825 (NY)
Practice address
6450 Anderegg Dr
Rome, NY 13440-7321
Phone
(315) 825-1233
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Advanced Practice Nurse

State licenses

LicenseStateTypeSpecialty
334825NYMDDiagnostic Radiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
164W00000X 334825 NY Yes

Addresses

Primary practice location

6450 Anderegg Dr
Rome, NY 13440-7321

Mailing address

6450 Anderegg Dr
Rome, NY 13440-7321
Phone (315) 825-1233

Other providers in Rome, NY

All providers in Rome, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.