Provider Demographics
NPI:1093713638
Name:BERNSTEIN, JONATHAN A (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:BERNSTEIN
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 1:4665 E GALBRAITH RD FL 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2783
Mailing Address - Country:US
Mailing Address - Phone:513-931-0775
Mailing Address - Fax:513-931-0798
Practice Address - Street 1:4665 E GALBRAITH RD FL 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2783
Practice Address - Country:US
Practice Address - Phone:513-931-0775
Practice Address - Fax:513-931-0779
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 053762207R00000X, 207K00000X
OH35-05-3761-B207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E61028Medicare UPIN
OHBE0676511Medicare ID - Type Unspecified
OH0793913Medicaid