MEDICARE: DAVID M BENDERSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	D0065278	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568597334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M BENDERSON M.D.

Provider Business Mailing Address
First Line	:	1200 E.RIDGEWOOD AVENUE
Second Line	:	SUITE 213WEST
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3937
Country	:	US
Telephone Number	:	201-612-0044
Fax Number	:	201-612-9446

Provider Business Practice Location Address
First Line	:	1200 E. RIDGEWOOD AVENUE
Second Line	:	SUITE 213 WEST
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3937
Country	:	US
Telephone Number	:	201-612-0044
Fax Number	:	201-612-9446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	06/26/2018

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