Healthcare Provider Details

I. General information

NPI: 1982631578
Provider Name (Legal Business Name): ALAN S BRONSTEIN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 VARNUM ST NE
WASHINGTON DC
20017
US

IV. Provider business mailing address

1150 VARNUM ST NE
WASHINGTON DC
20017
US

V. Phone/Fax

Practice location:
  • Phone: 202-448-4041
  • Fax:
Mailing address:
  • Phone: 202-448-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN48524
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN48524
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: