Basic Information
| Provider Information | |||||||||
| NPI: | 1770796971 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENANTE-HAWKINS | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 WYGATE DR | ||||||||
| Address2: | |||||||||
| City: | EGG HARBOR TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082345719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096455045 | ||||||||
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| Practice Location | |||||||||
| Address1: | 223 N MAIN ST STE 101 | ||||||||
| Address2: | |||||||||
| City: | CAPE MAY CH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082102182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094657557 | ||||||||
| FaxNumber: | 6094659383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 02/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 25MP00136900 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.