Healthcare Provider Details

I. General information

NPI: 1609884774
Provider Name (Legal Business Name): HOWARD Y BERNSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN PEDRO DR SE
ALBUQUERQUE NM
87108-5153
US

IV. Provider business mailing address

18 CANADA VISTA DR.
SANDIA PARK NM
87047
US

V. Phone/Fax

Practice location:
  • Phone: 505-256-2793
  • Fax:
Mailing address:
  • Phone: 505-281-4970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number90-154
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: