Healthcare Provider Details

I. General information

NPI: 1053314955
Provider Name (Legal Business Name): JAY M. BERNSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 RIDGEDALE AVE
CEDAR KNOLLS NJ
07927-2109
US

IV. Provider business mailing address

9 JACOB ARNOLD RD
MORRISTOWN NJ
07960-3406
US

V. Phone/Fax

Practice location:
  • Phone: 973-326-8895
  • Fax: 973-326-6805
Mailing address:
  • Phone: 973-326-8895
  • Fax: 973-326-6805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA039964
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: