Sandra Benckendorf
Individual provider Active NPI Family Medicine Physician · Berlin, NH
NPI 1932299237 · NPPES record last updated Dec 2, 2014
Key facts
- NPI
- 1932299237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 15334 (NH)
- Practice address
- 59 Page Hill Rd
Berlin, NH 03570-3531 - Phone
- (603) 752-2900
- Fax
- (603) 752-3727
- NPI assigned
- Oct 15, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-060813 | IL | MD | Family Medicine Physician |
| 15334 | NH | MD | Family Medicine Physician |
| 16334 | NH | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-060813 | IL | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 036-060813 | IL | |
| Family Medicine Physician | 207Q00000X | 15334 | NH | Yes |
Addresses
Primary practice location
59 Page Hill Rd
Berlin, NH 03570-3531
Mailing address
133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036060813 | Medicaid | IL | |
| 3071951 | Medicaid | NH |
Other providers in Berlin, NH
- Jaimie Lynn Baillargeon
- Heather Lee Beaudry
- Jesse Rye Beaudry
- Lynn Marie Beede
- Angie L Belouin
- Cody James Benjamin
- Kayley Bennett
- Berlin Dental Care
- Berlin Emergency Medical Services Inc
- Berlin Public Schools
All providers in Berlin, NH · Family Medicine Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.