Provider Demographics
NPI:1093818155
Name:BERNSTEIN, KARLA (APRN)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WESTWOOD AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-573-1425
Mailing Address - Fax:203-573-8236
Practice Address - Street 1:60 WESTWOOD AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-573-1425
Practice Address - Fax:203-573-8236
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000057363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S81469Medicare UPIN