MEDICARE: DR. LAWRENCE H BERNSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	155817	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	710779	OTHER	HARVARD PILGRIM
2	J18507	OTHER	BCBS OF MA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	017816	OTHER	CONNECTICARE OF MA
5	974611	OTHER	NETWORK HEALTH
6	000000001890	OTHER	BOSTON MEDICAL CENTER HNP
7	J18507	OTHER	HMO BLUE
8	043202198007	OTHER	TRICARE
9	5311957012	OTHER	CIGNA
10	24948	OTHER	HEALTH NEW ENGLAND

General Provider Information

NPI Number	:	1093715906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE H BERNSTEIN MD

Provider Business Mailing Address
First Line	:	260 NEW LUDLOW RD
Second Line	:
City	:	CHICOPEE
State	:	MA
Zip	:	01020-4324
Country	:	US
Telephone Number	:	413-533-3470
Fax Number	:	413-533-6859

Provider Business Practice Location Address
First Line	:	262 NEW LUDLOW RD
Second Line	:
City	:	CHICOPEE
State	:	MA
Zip	:	01020-4324
Country	:	US
Telephone Number	:	413-552-3250
Fax Number	:	413-552-3255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	01/18/2008

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Directions to “ DR. LAWRENCE H BERNSTEIN MD” Practice Location

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