Robert Benedetto

Individual provider Active NPI Behavior Technician · Stratford, CT

NPI 1962968693 · NPPES record last updated Feb 19, 2019

Key facts

NPI
1962968693
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-18-73752 (CT)
Practice address
355 Housatonic Ave
Stratford, CT 06615-6025
Phone
(203) 581-0537
NPI assigned
Feb 19, 2019
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
RBT-18-73752CTMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-73752 CT Yes

Addresses

Primary practice location

355 Housatonic Ave
Stratford, CT 06615-6025

Mailing address

355 Housatonic Ave
Stratford, CT 06615-6025
Phone (203) 581-0537

Other practice location 1

225 Danbury Rd
Wilton, CT 06897-4007
Phone (203) 581-0537

Other providers in Stratford, CT

All providers in Stratford, CT · Behavior Technician in Connecticut

Sources for this page

Verify at the official NPI Registry.