=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447433354
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UDELL BERNSTEIN MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2007
-----------------------------------------------------
Last Update Date | 05/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1295 COLORADO BLVD
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80206-3615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-355-7650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1295 COLORADO BLVD
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80206-3615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-355-7650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. UDELL L BERNSTEIN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 303-355-7650
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 16211
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------