Basic Information
| Provider Information | |||||||||
| NPI: | 1003006271 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENEZRA | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 827 | ||||||||
| Address2: | |||||||||
| City: | KENNEBUNK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040430827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076086864 | ||||||||
| FaxNumber: | 8889724103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1232 PORTLAND RD | ||||||||
| Address2: | |||||||||
| City: | ARUNDEL | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040468104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076086864 | ||||||||
| FaxNumber: | 2075027211 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 1900 | ME | N | Allopathic & Osteopathic Physicians | Family Medicine | 204D00000X | 1900 | ME | Y | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM |
No ID Information.