Provider Demographics
NPI:1407970692
Name:BENDER, SHEILA SIDNEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:SIDNEY
Last Name:BENDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 COLUMBIA TPKE
Mailing Address - Street 2:SUITE 202 B
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2117
Mailing Address - Country:US
Mailing Address - Phone:973-765-0749
Mailing Address - Fax:
Practice Address - Street 1:123 COLUMBIA TPKE
Practice Address - Street 2:SUITE 202 B
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2117
Practice Address - Country:US
Practice Address - Phone:973-765-0749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSIO1211103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist