Healthcare Provider Details

I. General information

NPI: 1568440659
Provider Name (Legal Business Name): MINDY ROBIN BERSTEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MANETTO HILL RD SUITE 308
PLAINVIEW NY
11803-1311
US

IV. Provider business mailing address

30 RODEO DR
SYOSSET NY
11791-2209
US

V. Phone/Fax

Practice location:
  • Phone: 516-935-4290
  • Fax: 516-935-4885
Mailing address:
  • Phone: 516-935-4290
  • Fax: 516-935-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number142890-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: