Healthcare Provider Details

I. General information

NPI: 1093791212
Provider Name (Legal Business Name): JAY BERNSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9145 GOVERNORS WAY
CINCINNATI OH
45249-2037
US

IV. Provider business mailing address

6670 GLEN ACRES DR
CINCINNATI OH
45237
US

V. Phone/Fax

Practice location:
  • Phone: 513-845-8655
  • Fax:
Mailing address:
  • Phone: 513-600-5473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberBB4761222
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35076065
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-0076065
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberBE4044736
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: