Provider Demographics
NPI:1407255516
Name:BENTLEY, MADELINE (CNA, CHHA)
Entity Type:Individual
Prefix:MISS
First Name:MADELINE
Middle Name:
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:CNA, CHHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4003
Mailing Address - Country:US
Mailing Address - Phone:201-907-0726
Mailing Address - Fax:
Practice Address - Street 1:315 LOCUST ST
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4003
Practice Address - Country:US
Practice Address - Phone:201-907-0726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health