Provider Demographics
NPI:1154395838
Name:BENOTTI, PETER N (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:N
Last Name:BENOTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-4903
Practice Address - Country:US
Practice Address - Phone:570-271-6439
Practice Address - Fax:570-271-6852
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06316500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
223431049OtherHORIZON BCBS
NJP4026641OtherOXFORD HEALTH PLANS
100049953205OtherUHC COMMUNITY & STATE AMERICHOICE
6173576OtherAETNA HMO PCP
00000499532OtherUHC COMMERCIAL & MEDICARE
NJ0188611Medicaid
NJ0854147000OtherAMERIHEALTH
4208590OtherAETNA PPO
0127120OtherCIGNA
1154295838OtherCOVENTRY & FIRST HEALTH
NJ60052498OtherHORIZON NJ HEALTH
00000499532OtherUHC COMMERCIAL & MEDICARE
4208590OtherAETNA PPO