Healthcare Provider Details

I. General information

NPI: 1255509980
Provider Name (Legal Business Name): ERAN BORNSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 FIRST AVE. BELLEVUE HOSPITAL, DEPARTMENT OF OBGYN
NEW YORK NY
10016
US

IV. Provider business mailing address

147 SAINT NICHOLAS AVE # 3
BROOKLYN NY
11237-4439
US

V. Phone/Fax

Practice location:
  • Phone: 212-262-0223
  • Fax:
Mailing address:
  • Phone: 718-417-1064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number247490
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: