Provider Demographics
NPI:1811900426
Name:BIENSTOCK, ALAN MARC (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARC
Last Name:BIENSTOCK
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 1:150 BROADWAY
Mailing Address - Street 2:RM 1110
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4357
Mailing Address - Country:US
Mailing Address - Phone:917-257-7560
Mailing Address - Fax:212-962-1246
Practice Address - Street 1:150 BROADWAY
Practice Address - Street 2:RM 1110
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4357
Practice Address - Country:US
Practice Address - Phone:917-257-7560
Practice Address - Fax:212-962-1246
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234485208200000X
NJ25MA07827500208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery