Provider Demographics
NPI:1386199214
Name:BENDER, SARAH AMANDA
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:AMANDA
Last Name:BENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:AMANDA
Other - Last Name:SMELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 W 235TH ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1827
Mailing Address - Country:US
Mailing Address - Phone:917-273-2311
Mailing Address - Fax:
Practice Address - Street 1:500 W 235TH ST
Practice Address - Street 2:APT 2G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1827
Practice Address - Country:US
Practice Address - Phone:917-273-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-21
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist