Provider Demographics
NPI:1538315643
Name:BENEDETTO, FRANK (PT, DPT, OCS, SCS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:BENEDETTO
Suffix:
Gender:M
Credentials:PT, DPT, OCS, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 WYCKOFF AVE
Mailing Address - Street 2:UNIT 361
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1438
Mailing Address - Country:US
Mailing Address - Phone:201-538-7131
Mailing Address - Fax:
Practice Address - Street 1:465 BOULEVARD
Practice Address - Street 2:BUILDING E
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2039
Practice Address - Country:US
Practice Address - Phone:201-538-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01285700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist