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General NPI Number Information
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NPI Number | 1417195843
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Entity Type | Individual
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Provider Name | EVAN ANDREW BERNSTEIN MS
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Gender | Male
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 88 NEW DORP PLZ S STE 105
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2902
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Country | US
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Telephone | 718-980-7700
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Fax | 718-980-7701
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Provider Business Mailing Address
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Address Line | 88 NEW DORP PLZ S STE 105
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2902
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Country | US
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Telephone | 718-980-7700
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Fax | 718-980-7701
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 41YA00075100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 002195-1
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License Number State | NY
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