Provider Demographics
NPI:1295906758
Name:BENDER, ALAN JEFFREY (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:JEFFREY
Last Name:BENDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1391
Mailing Address - Country:US
Mailing Address - Phone:216-464-5367
Mailing Address - Fax:216-464-7795
Practice Address - Street 1:2101 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1391
Practice Address - Country:US
Practice Address - Phone:216-464-5367
Practice Address - Fax:216-464-7795
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2932152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist