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General NPI Number Information
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NPI Number | 1134618952
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Entity Type | Individual
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Provider Name | RAITZEL CHEMDA BERNSTEIN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL FL 12
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City | NEW YORK
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State | NY
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Zip | 10029-6574
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Country | US
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Telephone | 212-423-4500
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Fax | 212-289-0126
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Provider Business Mailing Address
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Address Line | 1037 E 2ND ST
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City | BROOKLYN
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State | NY
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Zip | 11230-3341
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Country | US
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Telephone | 718-915-0921
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 060460
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License Number State | NY
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