Healthcare Provider Details

I. General information

NPI: 1750881157
Provider Name (Legal Business Name): RECOVERY SPOT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 IRVING PL FL 2
NEW YORK NY
10003-2202
US

IV. Provider business mailing address

67 IRVING PL FL 2
NEW YORK NY
10003-2202
US

V. Phone/Fax

Practice location:
  • Phone: 212-488-2024
  • Fax:
Mailing address:
  • Phone: 212-488-2024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT BIENENFELD
Title or Position: PHYSICIAN
Credential: MD
Phone: 212-488-2024