Provider Demographics
NPI:1316177124
Name:PROENCA, RICARDO BENROS (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:BENROS
Last Name:PROENCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-7037
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1205 LANGHRN NWTWN RD STE 403
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-710-4460
Practice Address - Fax:215-710-4465
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY235939-1207R00000X
PAMD418384207R00000X, 208M00000X
DEC1-0006784207R00000X
NJ25MA07537200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine