Healthcare Provider Details

I. General information

NPI: 1669490975
Provider Name (Legal Business Name): ANDREW M BERNSTEIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 NEWARK POMPTON TPKE
RIVERDALE NJ
07457-1141
US

IV. Provider business mailing address

500 FRANK W BURR BLVD STE 560
TEANECK NJ
07666-6804
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-5451
  • Fax: 973-831-5431
Mailing address:
  • Phone: 201-510-0910
  • Fax: 201-621-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MB08035400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: