Healthcare Provider Details

I. General information

NPI: 1033292420
Provider Name (Legal Business Name): PEDIATRIC & ADOLESCENT CARE OF SILVER SPRING, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 UNIVERSITY BLVD W STE 112
SILVER SPRING MD
20901-1969
US

IV. Provider business mailing address

344 UNIVERSITY BLVD W STE 112
SILVER SPRING MD
20901-1969
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-6730
  • Fax: 301-681-4268
Mailing address:
  • Phone: 301-681-6730
  • Fax: 301-681-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY PAUL BERNSTEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-681-6730