Provider Demographics
NPI:1871046037
Name:BINTLIFF, JASON JAMES
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:JAMES
Last Name:BINTLIFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-2101
Mailing Address - Country:US
Mailing Address - Phone:856-685-8185
Mailing Address - Fax:
Practice Address - Street 1:12 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:NJ
Practice Address - Zip Code:08051-2101
Practice Address - Country:US
Practice Address - Phone:856-685-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-24
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health