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General NPI Number Information
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NPI Number | 1174031041
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Entity Type | Organization
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Legal Business Name | SCOTT BIENENFELD, M.D., LLC
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 67 IRVING PL FL 2
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City | NEW YORK
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State | NY
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Zip | 10003-2202
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Country | US
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Telephone | 917-446-6829
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Fax |
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Provider Business Mailing Address
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Address Line | 95 WOODLAND PARK DR
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City | TENAFLY
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State | NJ
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Zip | 07670-3029
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT BIENENFELD
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Credential | MD
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Telephone | 917-446-6829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 211810
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License Number State | NY
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