Basic Information
| Provider Information | |||||||||
| NPI: | 1386104453 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENDRE | ||||||||
| FirstName: | HERSH | ||||||||
| MiddleName: | HEMANT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 116 JANWICH DR | ||||||||
| Address2: | |||||||||
| City: | MORGANVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077511479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322168893 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 FRUIT ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021142621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177262000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2019 | ||||||||
| LastUpdateDate: | 12/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 279688 | MA | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.