Healthcare Provider Details

I. General information

NPI: 1013954163
Provider Name (Legal Business Name): JOSEPH B BERNSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/26/2024
Certification Date: 02/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78-15 LINDEN BLVD SUITE B
HOWARD BEACH NY
11414
US

IV. Provider business mailing address

78-15 LINDEN BLVD SUITE B
HOWARD BEACH NY
11414
US

V. Phone/Fax

Practice location:
  • Phone: 718-674-7896
  • Fax: 718-674-7904
Mailing address:
  • Phone: 718-674-7896
  • Fax: 718-674-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number203731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: