Individual
MARIE A BENTSIANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
40 W BRIGHTON AVE, SUITE 103, BROOKLYN, NY 11224-4901
(718) 743-0464
(718) 996-1123
Mailing address
40 W BRIGHTON AVE, SUITE 103, BROOKLYN, NY 11224-4901
(718) 743-0464
(718) 996-1123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
210753
NY
207RN0300X
Nephrology Physician
Primary
210753
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02359704
—
NY
01
—
3399506
GHI
NY
01
—
P2908147
OXFORD
NY
Enumeration date
07/07/2005
Last updated
06/04/2013
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