Provider Demographics
NPI:1437139649
Name:BERNSTEIN, LEONARD H (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:H
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 MCCRACKEN RD
Mailing Address - Street 2:#200
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2933
Mailing Address - Country:US
Mailing Address - Phone:216-581-9222
Mailing Address - Fax:216-581-7558
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:#200
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2933
Practice Address - Country:US
Practice Address - Phone:216-581-9222
Practice Address - Fax:216-581-7558
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35026793174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0364162Medicare PIN