Provider Demographics
NPI:1124313630
Name:BENINATI, LAWRENCE (RPH)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:BENINATI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1039
Mailing Address - Country:US
Mailing Address - Phone:203-445-9537
Mailing Address - Fax:
Practice Address - Street 1:151 NORTH ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-1039
Practice Address - Country:US
Practice Address - Phone:203-445-9537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT0010885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist