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General NPI Number Information
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NPI Number | 1154699114
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Entity Type | Individual
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Provider Name | LISA S BENDER PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 72 FARMEDGE RD
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City | LEVITTOWN
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State | NY
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Zip | 11756-5202
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Country | US
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Telephone | 516-827-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 5 NORTH ST.
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City | SYOSSET
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State | NY
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Zip | 11791-2712
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Country | US
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Telephone | 516-364-5378
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 006924-1
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License Number State | NY
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