Provider Demographics
NPI:1518035930
Name:BERNSTEIN, STUART MARK (DPM)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:MARK
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:119 W 57TH ST
Mailing Address - Street 2:SUITE 717
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2303
Mailing Address - Country:US
Mailing Address - Phone:212-265-2253
Mailing Address - Fax:212-247-1007
Practice Address - Street 1:119 W 57TH ST
Practice Address - Street 2:SUITE 717
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2303
Practice Address - Country:US
Practice Address - Phone:212-265-2253
Practice Address - Fax:212-247-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN-003350213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP35391Medicare ID - Type Unspecified
NYT51053Medicare UPIN