Provider Demographics
NPI:1326005919
Name:BERNSTEIN, DEBORAH W (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:W
Last Name:BERNSTEIN
Suffix:
Gender:F
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:N19W23993 RIDGEVIEW PKWY W STE 100
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1031
Mailing Address - Country:US
Mailing Address - Phone:262-547-3352
Mailing Address - Fax:262-547-9142
Practice Address - Street 1:N19W23993 RIDGEVIEW PKWY W STE 100
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1031
Practice Address - Country:US
Practice Address - Phone:262-547-3352
Practice Address - Fax:262-547-9142
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI45516-020207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34359000OtherMANAGED HEALTH SERVICES
WI747042OtherMOHAWK
WI391101335OtherWI PHYS SERVICE WPS
WI34359000Medicaid
WI822601OtherVIPA
WI7562466OtherAETNA
WI391101335OtherWI HEALTH INS RISK PROG
WI399478841000OtherCOMPCARE
WIP00025099OtherRAILROAD MEDICARE
WI0800442OtherUNITED HEALTHCARE
WI103435OtherHEALTH ALLIANCE
WI34359000OtherABRI