MEDICARE: DR. ABEL FARNUM HENDY JR. D.D.S.

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	1223G0001X	General Practice Dentistry	042507	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164646964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABEL FARNUM HENDY JR. D.D.S.

Provider Business Mailing Address
First Line	:	632 W 147TH ST
Second Line	:	SUITE B
City	:	NEW YORK
State	:	NY
Zip	:	10031-4318
Country	:	US
Telephone Number	:	212-234-5678
Fax Number	:	212-234-5678

Provider Business Practice Location Address
First Line	:	632 W 147TH ST
Second Line	:	SUITE B
City	:	NEW YORK
State	:	NY
Zip	:	10031-4318
Country	:	US
Telephone Number	:	212-234-5678
Fax Number	:	212-234-5678

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/09/2007

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Directions to “ DR. ABEL FARNUM HENDY JR. D.D.S.” Practice Location

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