Provider Demographics
NPI:1033209879
Name:HEERSINK, BERNHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNHARD
Middle Name:
Last Name:HEERSINK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HIGHLAND AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950
Mailing Address - Country:US
Mailing Address - Phone:978-462-8751
Mailing Address - Fax:978-462-8920
Practice Address - Street 1:21 HIGHLAND AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950
Practice Address - Country:US
Practice Address - Phone:978-462-8751
Practice Address - Fax:978-462-8920
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37852207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAD23039BSOtherBLUE CROSS BLUE SHIELD
D88225Medicare UPIN
MAD23039BSOtherBLUE CROSS BLUE SHIELD