Healthcare Provider Details

I. General information

NPI: 1043218597
Provider Name (Legal Business Name): STEVEN R BENDER PC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 N MAIN ST
PLEASANTVILLE NJ
08232-1036
US

IV. Provider business mailing address

1425 N MAIN ST
PLEASANTVILLE NJ
08232-1036
US

V. Phone/Fax

Practice location:
  • Phone: 609-646-4220
  • Fax: 609-646-0628
Mailing address:
  • Phone: 609-646-4220
  • Fax: 609-646-0628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00121700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: