Provider Demographics
NPI:1811669831
Name:PENDL, BETHANY JANE
Entity type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:JANE
Last Name:PENDL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4284 BIRCH RUN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-9518
Mailing Address - Country:US
Mailing Address - Phone:716-790-1629
Mailing Address - Fax:
Practice Address - Street 1:3260 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ALLEGANY
Practice Address - State:NY
Practice Address - Zip Code:14706-9532
Practice Address - Country:US
Practice Address - Phone:716-543-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist