Organization
ERIC BENTOLILA, M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARISSA VEGA (OFFICE MANAGER)
(973) 874-8459
Entity
Organization
Contact information
Practice address
615 FRANKLIN TURNPIKE, RIDGEWOOD, NJ 07450-0745
(201) 447-1700
(201) 447-9386
Mailing address
150 FRANKLIN AVE, RIDGEWOOD, NJ 07450-3206
(201) 447-1700
(201) 447-9386
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA07057600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371713000
AMERIHEALTH GROUP#
NJ
Enumeration date
03/23/2007
Last updated
11/04/2019
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