Provider Demographics
NPI:1437470663
Name:BERNSTEIN, JENNIFER SUSAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SUSAN
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:SUSAN
Other - Last Name:KALOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7252 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2100
Mailing Address - Country:US
Mailing Address - Phone:718-326-0055
Mailing Address - Fax:718-326-0637
Practice Address - Street 1:7252 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2100
Practice Address - Country:US
Practice Address - Phone:718-326-0055
Practice Address - Fax:718-326-0637
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032070-1225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist