Provider Demographics
NPI:1164646964
Name:HENDY, ABEL FARNUM JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABEL
Middle Name:FARNUM
Last Name:HENDY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 W 147TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-4318
Mailing Address - Country:US
Mailing Address - Phone:212-234-5678
Mailing Address - Fax:212-234-5678
Practice Address - Street 1:632 W 147TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4318
Practice Address - Country:US
Practice Address - Phone:212-234-5678
Practice Address - Fax:212-234-5678
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0425071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01161715Medicaid