MEDICARE: DR. PAUL R BERNSTEIN O.D.

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	152WX0102X	Occupational Vision Optometrist	TUV004755-1	NY
2	152W00000X	Optometrist	TUV004755-1	NY
3	152WS0006X	Sports Vision Optometrist	TUV004755-1	NY
4	152WP0200X	Pediatric Optometrist	TUV004755-1	NY
5	152WC0802X	Corneal and Contact Management Optometrist	TUV004755-1	NY
6	152WL0500X	Low Vision Rehabilitation Optometrist	TUV004755-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1215997937	OTHER	NY	NPI

General Provider Information

NPI Number	:	1215997937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL R BERNSTEIN O.D.

Provider Business Mailing Address
First Line	:	1133 WESTCHESTER AVENUE
Second Line	:	BUILDING A, SUITE N-008
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604
Country	:	US
Telephone Number	:	914-948-0304
Fax Number	:	914-948-0365

Provider Business Practice Location Address
First Line	:	1133 WESTCHESTER AVENUE
Second Line	:	BUILDING A, SUITE N-008
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604
Country	:	US
Telephone Number	:	914-948-0304
Fax Number	:	914-948-0365

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

Provider Enumeration Date	:	03/25/2006
Last Update Date	:	08/08/2023

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