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General NPI Number Information
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NPI Number | 1184791881
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Entity Type | Individual
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Provider Name | JUDITH E. BERNSTEIN OD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3100 JOHNSON FERRY RD
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City | MARIETTA
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State | GA
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Zip | 30062-5657
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Country | US
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Telephone | 770-992-5954
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Fax | 770-518-0513
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Provider Business Mailing Address
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Address Line | 7475 HALF PENNY PL
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City | ATLANTA
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State | GA
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Zip | 30350-5021
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Country | US
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Telephone | 770-396-0251
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | GA992
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License Number State | GA
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