MEDICARE: GAIL BENDHEIM PSYD

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	103T00000X	Psychologist	011357	NY

General Provider Information

NPI Number	:	1326269762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL BENDHEIM PSYD

Provider Business Mailing Address
First Line	:	4555 HENRY HUDSON PKWY
Second Line	:	SUITE 102
City	:	BRONX
State	:	NY
Zip	:	10471-3836
Country	:	US
Telephone Number	:	718-601-2649
Fax Number	:

Provider Business Practice Location Address
First Line	:	4555 HENRY HUDSON PKWY
Second Line	:	SUITE 102
City	:	BRONX
State	:	NY
Zip	:	10471-3836
Country	:	US
Telephone Number	:	718-601-2649
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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