Susan Leslie Bendix, M.S.E.D.
Individual provider Active NPI Specialist · Merrick, NY
NPI 1104188150 · NPPES record last updated Jun 14, 2012
Key facts
- NPI
- 1104188150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 8010 (NY)
- Practice address
- 2119 Oliver Way
Merrick, NY 11566-5425 - Phone
- (516) 868-4033
- NPI assigned
- Jun 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8010 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 8010 | NY | Yes |
Addresses
Primary practice location
2119 Oliver Way
Merrick, NY 11566-5425
Mailing address
2119 Oliver Way
Merrick, NY 11566-5425
Phone (516) 868-4033
Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.