MEDICARE: MR. JOEL M 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	174400000X	Specialist	087917	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1009174	OTHER	NY	INDEPENDENT HEALTH

General Provider Information

NPI Number	:	1184616559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOEL M BERNSTEIN MD

Provider Business Mailing Address
First Line	:	2430 N FOREST RD
Second Line	:	SUITE 150
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1535
Country	:	US
Telephone Number	:	716-636-7613
Fax Number	:	716-636-7616

Provider Business Practice Location Address
First Line	:	2430 N FOREST RD
Second Line	:	SUITE 150
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1535
Country	:	US
Telephone Number	:	716-636-7613
Fax Number	:	716-636-7616

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/08/2007

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