Individual
TYRONE BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
183 SOUTH ORANGE AVENUE, F-LEVEL, NEWARK, NJ 07107
(973) 972-8930
(973) 972-0812
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
25MA07944500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097446
—
NJ
Enumeration date
11/13/2006
Last updated
08/20/2009
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