Provider Demographics
NPI:1922113588
Name:BENDER, SCOTT R (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:BENDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1223
Mailing Address - Country:US
Mailing Address - Phone:203-967-8888
Mailing Address - Fax:203-967-1111
Practice Address - Street 1:1200 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1223
Practice Address - Country:US
Practice Address - Phone:203-967-8888
Practice Address - Fax:203-967-1111
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU66295Medicare UPIN