Provider Demographics
NPI:1063455137
Name:BERNSTEIN, SAMBRA H (MD)
Entity Type:Individual
Prefix:
First Name:SAMBRA
Middle Name:H
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3063
Mailing Address - Country:US
Mailing Address - Phone:908-722-2900
Mailing Address - Fax:908-722-1856
Practice Address - Street 1:215 UNION AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3063
Practice Address - Country:US
Practice Address - Phone:908-722-2900
Practice Address - Fax:908-722-1856
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04632800207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD04357400OtherCONTROLLED DANGEROOUS SUB
NJ0140406Medicaid
NJ25MA04632800OtherNJ MEDICAL LICENSE
BB1514745OtherFEDERAL DEA
NJ192006Medicare ID - Type UnspecifiedMEDICARE
BB1514745OtherFEDERAL DEA