MEDICARE: DR. HOWARD BENDITSKY PH.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	103TC0700X	Clinical Psychologist	000726	CT

General Provider Information

NPI Number	:	1477586824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD BENDITSKY PH.D.

Provider Business Mailing Address
First Line	:	88 NOBLE AVE
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-4738
Country	:	US
Telephone Number	:	203-877-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 NOBLE AVE
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-4738
Country	:	US
Telephone Number	:	203-877-6100
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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