Provider Demographics
NPI:1629160692
Name:BENDER, ADAM N (MD)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:N
Last Name:BENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1150 PARK AVENUE
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:212-876-5670
Mailing Address - Fax:212-410-6129
Practice Address - Street 1:1150 PARK AVENUE
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:212-876-5670
Practice Address - Fax:212-410-6129
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1040922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00717102Medicaid
C12468Medicare UPIN
NY956921Medicare ID - Type Unspecified