Provider Demographics
NPI:1386816601
Name:BERNFELD, ERICA E (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:E
Last Name:BERNFELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:EDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 MERCANTILE LANE
Mailing Address - Street 2:LARGO MEDICAL CENTER
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:301-618-5578
Mailing Address - Fax:
Practice Address - Street 1:1221 MERCANTILE LANE
Practice Address - Street 2:LARGO MEDICAL CENTER
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:301-618-5578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038292207W00000X
MDD0067650207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC173921ZF4Medicare PIN