Provider Demographics
NPI:1255931556
Name:BENDER, FREDERIC J
Entity type:Individual
Prefix:
First Name:FREDERIC
Middle Name:J
Last Name:BENDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10667 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44442-8762
Mailing Address - Country:US
Mailing Address - Phone:234-855-5091
Mailing Address - Fax:
Practice Address - Street 1:10667 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:44442-8762
Practice Address - Country:US
Practice Address - Phone:234-855-5091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide