Provider Demographics
NPI:1427306851
Name:MARAMARA, BENNADETTE CABALTICA (MD)
Entity type:Individual
Prefix:
First Name:BENNADETTE
Middle Name:CABALTICA
Last Name:MARAMARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-0650
Mailing Address - Fax:631-638-4170
Practice Address - Street 1:HSC T 16 RM 060
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0988
Practice Address - Country:US
Practice Address - Phone:631-444-3490
Practice Address - Fax:631-444-7518
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY287294207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease