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General NPI Number Information
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NPI Number | 1205018660
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Entity Type | Organization
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Legal Business Name | BERNHARD HEERSINK MD PC
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 21 HIGHLAND AVE SUITE 1
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City | NEWBURYPORT
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State | MA
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Zip | 01950
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Country | US
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Telephone | 978-462-8751
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Fax | 978-462-8920
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Provider Business Mailing Address
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Address Line | 21 HIGHLAND AVE SUITE 1
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City | NEWBURYPORT
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State | MA
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Zip | 01950
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Country | US
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Telephone | 978-462-8751
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Fax | 978-462-8920
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Authorized Official
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Title or Position | PRES
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Name | BERNHARD HEERSINK
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Credential | MD
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Telephone | 978-462-8751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 37852
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License Number State | MA
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