Provider Demographics
NPI:1144212275
Name:BERNSTEIN, MARTIN SEYMOUR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:SEYMOUR
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 1:2107 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5041
Mailing Address - Country:US
Mailing Address - Phone:718-434-3320
Mailing Address - Fax:718-377-6886
Practice Address - Street 1:2107 AVENUE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5041
Practice Address - Country:US
Practice Address - Phone:718-434-3320
Practice Address - Fax:718-377-6886
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079699207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
C05754Medicare UPIN
NY127051Medicare ID - Type Unspecified