MEDICARE: SCOTT BIENENFELD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MA07806800	NJ
2	2084P0800X	Psychiatry Physician	211810	NY

General Provider Information

NPI Number	:	1023049939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT BIENENFELD M.D.

Provider Business Mailing Address
First Line	:	275 CENTRAL PARK W
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10024-3015
Country	:	US
Telephone Number	:	212-579-7845
Fax Number	:	212-579-7849

Provider Business Practice Location Address
First Line	:	275 CENTRAL PARK W
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10024-3015
Country	:	US
Telephone Number	:	212-579-7845
Fax Number	:	212-579-7849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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Directions to “ SCOTT BIENENFELD M.D.” Practice Location

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