Healthcare Provider Details

I. General information

NPI: 1881807063
Provider Name (Legal Business Name): ROBERT A BERNSTEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 P ST. N.W. SUITE 407
WASHINGTON DC
20036
US

IV. Provider business mailing address

2804 MCKINLEY PL. N.W.
WASHINGTON DC
20015
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-0996
  • Fax:
Mailing address:
  • Phone: 202-244-0172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1158
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPSY1158
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: