1205932068

Everything you always wanted to know about BENEDICTO L. PEDRO M.D. but were afraid to ask.

BENEDICTO L. PEDRO M.D.

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
BENEDICTO L. PEDRO M.D.
Gender:
Male
Enumeration date:
2006-09-16
Last update date:
2007-07-09
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
A64007 Medicare UPIN none NY
80F951 Medicare ID-Type Undpecified NO ACTIVE NY
00961968 Medicaid none NY

Taxonomies

Taxonomy State License Number Primary?
174400000X Specialist NY 165687 Y

Phone Numbers

Type Number
Practice Location Address Telephone Number 809 724 0874

Addresses

Type Address City State Postal Country
Mailing Address CALLE U # 17 URB. CASILDA SANTIAGO SANTIAGO 0 SANTIAGO
Practice Location Address CALLE U # 17 URB. CASILDA SANTIAGO SANTIAGO 0 SANTIAGO