Provider Demographics
NPI:1346785714
Name:BRONSTEIN, RIFKA
Entity Type:Individual
Prefix:MRS
First Name:RIFKA
Middle Name:
Last Name:BRONSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-1012
Mailing Address - Country:US
Mailing Address - Phone:718-633-6666
Mailing Address - Fax:
Practice Address - Street 1:1049 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1012
Practice Address - Country:US
Practice Address - Phone:718-633-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1074674161174400000X
NY1075472161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist