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General NPI Number Information
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NPI Number | 1508941535
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Entity Type | Organization
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Legal Business Name | RALEIGH PEDIATRIC ASSOCIATES, PA
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1921 FALLS VALLEY DR
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City | RALEIGH
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State | NC
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Zip | 27615-3446
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Country | US
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Telephone | 919-872-0250
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Fax |
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Provider Business Mailing Address
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Address Line | 1921 FALLS VALLEY DR
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City | RALEIGH
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State | NC
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Zip | 27615-3446
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Country | US
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Telephone | 919-872-0250
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. JERRY C. BERNSTEIN
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Credential | M.D.
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Telephone | 919-872-0250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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