MEDICARE: PAULA BERNSTEIN PHD

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	103TC0700X	Clinical Psychologist	007924	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992875108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA BERNSTEIN PHD

Provider Business Mailing Address
First Line	:	318 E 120TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3113
Country	:	US
Telephone Number	:	212-348-4868
Fax Number	:	212-348-4868

Provider Business Practice Location Address
First Line	:	111 LAKE AVE
Second Line	:	SUITE 4
City	:	TUCKAHOE
State	:	NY
Zip	:	10707-3935
Country	:	US
Telephone Number	:	914-793-0533
Fax Number	:

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	03/06/2012

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