Provider Demographics
NPI:1003876723
Name:BERNSTEIN, IRA J (OD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:J
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:701 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-3002
Mailing Address - Country:US
Mailing Address - Phone:914-948-0304
Mailing Address - Fax:914-948-0365
Practice Address - Street 1:701 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-3002
Practice Address - Country:US
Practice Address - Phone:914-948-0304
Practice Address - Fax:914-948-0365
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV002123-1152W00000X, 152WL0500X, 152WP0200X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1003876723OtherNPI
NY1003876723OtherNPI
NYC97241Medicare PIN