Individual
EDWARD BENTLYEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
171 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
(212) 305-5098
Mailing address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 342-5155
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ00501000
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
F307476-1
NY
363LA2200X
Adult Health Nurse Practitioner
H140070
IA
Other
Enumeration date
08/27/2015
Last updated
10/02/2015
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