Provider Demographics
NPI:1912230137
Name:ALAN BIENSTOCK, MD PC
Entity Type:Organization
Organization Name:ALAN BIENSTOCK, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC AND RECONSTRUCTIVE SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:BIENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-257-7560
Mailing Address - Street 1:46 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0305
Mailing Address - Country:US
Mailing Address - Phone:917-257-7560
Mailing Address - Fax:212-628-5799
Practice Address - Street 1:46 E 82ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0305
Practice Address - Country:US
Practice Address - Phone:917-257-7560
Practice Address - Fax:212-628-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234485208200000X
NJ25MA07827500208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02685041Medicaid
NJ086721Medicare PIN
NJI22836Medicare UPIN
NYI22836Medicare UPIN
NY1709F1Medicare PIN