Provider Demographics
NPI:1518334168
Name:BERNSTEIN, JACQUELINE BRIANNE (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:BRIANNE
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 LAVENDER HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3427
Mailing Address - Country:US
Mailing Address - Phone:973-727-7811
Mailing Address - Fax:
Practice Address - Street 1:404 LAVENDER HILL DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3427
Practice Address - Country:US
Practice Address - Phone:973-727-7811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016589225X00000X
MD06963225X00000X, 225XP0200X
NJ46TR00882200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics