Basic Information
| Provider Information | |||||||||
| NPI: | 1154424224 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENDHEIM | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 COLUMBIA STREE | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454731188 | ||||||||
| FaxNumber: | 8454730896 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 COLUMBIA STREET | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454731188 | ||||||||
| FaxNumber: | 8454730896 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2006 | ||||||||
| LastUpdateDate: | 09/07/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 195812 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.