Provider Demographics
NPI:1780100420
Name:BENTZEL, FREDERICK HENRY III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:HENRY
Last Name:BENTZEL
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101
Practice Address - Country:US
Practice Address - Phone:412-364-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP451739OtherPHARMACIST LICENSE
RP451739OtherPHARMACIST