Provider Demographics
NPI:1346522901
Name:BENDER, THOMAS FRANCIS JR (RP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:BENDER
Suffix:JR
Gender:M
Credentials:RP
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:FRANCIS
Other - Last Name:BENDER
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7 FULLING MILL LN
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1278
Mailing Address - Country:US
Mailing Address - Phone:732-946-0507
Mailing Address - Fax:
Practice Address - Street 1:1311 RTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5049
Practice Address - Country:US
Practice Address - Phone:732-349-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01415900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist