Provider Demographics
NPI:1588666192
Name:BENDER, JOHN CHRISTOPHER (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:BENDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:2 ROSELL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1400
Mailing Address - Country:US
Mailing Address - Phone:518-877-8900
Mailing Address - Fax:518-877-8908
Practice Address - Street 1:2 ROSELL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1400
Practice Address - Country:US
Practice Address - Phone:518-877-8900
Practice Address - Fax:518-877-8908
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021435-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY200857640OtherTRPN/THREE RIVERS
NY982945OtherGALAXY HEALTH NETWORK
NY200857640OtherNOVA
NY10070721OtherCDPHP(GRP M479200857640)
NYQ10Z01OtherBLUE CROSS
NY00200857640OtherUNIVERA
NY416174001OtherGROUP-BLUE SHIELD NENY
NY7672208OtherAETNA
NY828360OtherMPN
NY200857640OtherTRICARE - GROUP
NY200857640OtherUNITED HEALTH CARE
NY362798OtherMVP
NY6697631OtherGHI PPO/CBP
NY000000081191OtherGHI HMO
NY000403779003OtherBLUE SHIELD NENY
NY200857640OtherSTATEWIDE
NY200857640OtherSHARED HEALTH
NY828360OtherMPN
NY982945OtherGALAXY HEALTH NETWORK