Provider Demographics
NPI:1336468008
Name:STEVEN R. BENDER,P.C.
Entity Type:Organization
Organization Name:STEVEN R. BENDER,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:606-646-4220
Mailing Address - Street 1:1425 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-1036
Mailing Address - Country:US
Mailing Address - Phone:609-646-4220
Mailing Address - Fax:609-646-0628
Practice Address - Street 1:1425 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-1036
Practice Address - Country:US
Practice Address - Phone:609-646-4220
Practice Address - Fax:609-646-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00121700302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization