Provider Demographics
NPI:1518012897
Name:BERNSTEIN, LARRY N (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:N
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:PO BOX 348
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-0348
Mailing Address - Country:US
Mailing Address - Phone:215-369-2742
Mailing Address - Fax:215-369-2742
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:LANKENAU HOSPITAL - PMR DEPT.
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-3391
Practice Address - Fax:484-476-8005
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031713E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2512753OtherAETNA
PA421870OtherUNITED HEALTHCARE
PA0341362002OtherCIGNA
PA0102484000OtherKEYSTONE HEALTH PLAN EAST
PA447747OtherBLUE SHIELD
PA250012419OtherRR MEDICARE
PA48576OtherKEYSTONE MERCY HEALTH
PA0011010170002Medicaid
PA421870OtherUNITED HEALTHCARE
PAC34284Medicare UPIN