Provider Demographics
NPI:1467895771
Name:BERNSTEIN, MARISSA ELIZABETH
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ELIZABETH
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:ELIZABETH
Other - Last Name:SARDINHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:211 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3143
Mailing Address - Country:US
Mailing Address - Phone:508-236-8938
Mailing Address - Fax:508-236-7335
Practice Address - Street 1:211 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3143
Practice Address - Country:US
Practice Address - Phone:508-236-8938
Practice Address - Fax:508-236-7335
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine