Provider Demographics
NPI:1184673634
Name:BENTLEY, JAMES DAVID (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COLUMBUS CIR STE A
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3907
Mailing Address - Country:US
Mailing Address - Phone:866-909-7284
Mailing Address - Fax:908-272-1478
Practice Address - Street 1:300 COLUMBUS CIR STE A
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3907
Practice Address - Country:US
Practice Address - Phone:866-909-7284
Practice Address - Fax:908-272-1478
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09373000207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0652822Medicaid
OHBE0791157Medicare PIN
OHBE0791152Medicare PIN
OH0214360Medicaid