Provider Demographics
NPI:1154487676
Name:BENDELSTEIN, HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:BENDELSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 BEACH 6TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5439
Mailing Address - Country:US
Mailing Address - Phone:718-868-3063
Mailing Address - Fax:
Practice Address - Street 1:463 BEACH 6TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5439
Practice Address - Country:US
Practice Address - Phone:718-868-1095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160938207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00867969Medicaid
NYA62328Medicare UPIN
NY61691Medicare ID - Type Unspecified