Provider Demographics
NPI:1598508434
Name:BENDER, LAUREN E (MSN, AGNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:BENDER
Suffix:
Gender:F
Credentials:MSN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-1330
Mailing Address - Country:US
Mailing Address - Phone:201-540-6993
Mailing Address - Fax:
Practice Address - Street 1:148 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-1330
Practice Address - Country:US
Practice Address - Phone:201-540-6993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15090200363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology