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General NPI Number Information
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NPI Number | 1982959706
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Entity Type | Organization
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Legal Business Name | MICHAEL BERNSTEIN MDPC
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 275 CENTRAL AVE SUITE 2
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City | LAWRENCE
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State | NY
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Zip | 11559-1581
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Country | US
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Telephone | 718-641-4382
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Fax |
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Provider Business Mailing Address
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Address Line | 275 CENTRAL AVENUE SUITE 2
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City | LAWRENCE
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State | NY
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Zip | 11559
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Country | US
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Telephone | 718-641-4382
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL BERNSTEIN
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Credential | MD
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Telephone | 718-641-4382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00176392
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License Number State | NY
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