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General NPI Number Information
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NPI Number | 1487726675
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Entity Type | Individual
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Provider Name | ERIC Y. BENTOLILA MD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 615 FRANKLIN TURNPIKE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 201-447-1700
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Fax | 201-447-9386
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Provider Business Mailing Address
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Address Line | 615 FRANKLIN TURNPIKE FIRST FLOOR
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 201-447-1700
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Fax | 201-447-9386
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA07057600
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License Number State | NJ
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