Provider Demographics
NPI:1821150020
Name:BENTE, KATHLEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:BENTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2204
Mailing Address - Country:US
Mailing Address - Phone:201-666-4422
Mailing Address - Fax:201-722-0229
Practice Address - Street 1:249 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2204
Practice Address - Country:US
Practice Address - Phone:201-666-4422
Practice Address - Fax:201-722-0229
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 04346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU45424Medicare UPIN
NJBE419933Medicare ID - Type UnspecifiedPROVIDER ID #