Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 018692 | NY |
N | 103G00000X | Clinical Psychologist | 018692 | NY |
N | 103TC0700X | Clinical Psychologist | 018692 | NY |
NPI | 1225300205 |
---|---|
Provider Name | Dr. James Bender JR. |
First Address | New York, NY 10018-7151 |
Second Address | New York, NY 10018-7151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2012 |
Last Update Date | 06/02/2012 |