Provider Demographics
NPI:1225091663
Name:BERSTEIN, LARRY P (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:P
Last Name:BERSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MANETTO HILL RD
Mailing Address - Street 2:STE 202
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1311
Mailing Address - Country:US
Mailing Address - Phone:516-935-9200
Mailing Address - Fax:516-935-9220
Practice Address - Street 1:100 MANETTO HILL RD
Practice Address - Street 2:STE 202
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1311
Practice Address - Country:US
Practice Address - Phone:516-935-9200
Practice Address - Fax:516-935-9220
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2011-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY139098207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00703695Medicaid
NY00703695Medicaid
B17884Medicare UPIN