Healthcare Provider Details

I. General information

NPI: 1447917869
Provider Name (Legal Business Name): RYAN MICHAEL BERNSTEIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 WORCESTER RD
FRAMINGHAM MA
01702-0170
US

IV. Provider business mailing address

280 WORCESTER RD
FRAMINGHAM MA
01702-5356
US

V. Phone/Fax

Practice location:
  • Phone: 978-443-0989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number3689
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: