MEDICARE: DR. KAREN KERNBERG BARDENSTEIN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4067	OH

General Provider Information

NPI Number	:	1609807429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN KERNBERG BARDENSTEIN PH.D.

Provider Business Mailing Address
First Line	:	12429 CEDAR RD
Second Line	:	SUITE 18
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3199
Country	:	US
Telephone Number	:	216-229-4200
Fax Number	:	216-229-4485

Provider Business Practice Location Address
First Line	:	12429 CEDAR RD
Second Line	:	SUITE 18
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3199
Country	:	US
Telephone Number	:	216-229-4200
Fax Number	:	216-229-4485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. KAREN KERNBERG BARDENSTEIN PH.D.” Practice Location

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