Healthcare Provider Details
I. General information
NPI: 1801391297
Provider Name (Legal Business Name): MICHELLE BERNSHTEYN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/27/2018
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 GUTHRIE SQ
SAYRE PA
18840-1625
US
IV. Provider business mailing address
1 GUTHRIE SQ
SAYRE PA
18840-1625
US
V. Phone/Fax
- Phone: 570-887-2367
- Fax:
- Phone: 570-888-5858
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | MD489456 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: