Provider Demographics
NPI:1275516098
Name:FURSHPAN, BERNARD (DC)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:FURSHPAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5910
Mailing Address - Country:US
Mailing Address - Phone:631-665-1150
Mailing Address - Fax:
Practice Address - Street 1:1150 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5910
Practice Address - Country:US
Practice Address - Phone:631-665-1150
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX1528100Medicare ID - Type Unspecified
NYT52168Medicare UPIN