Provider Demographics
NPI:1558364877
Name:BERNSTEIN, HARVEY ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:ALAN
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 LARGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1725
Mailing Address - Country:US
Mailing Address - Phone:215-342-8124
Mailing Address - Fax:
Practice Address - Street 1:7001 LARGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1725
Practice Address - Country:US
Practice Address - Phone:215-342-8124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002069L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU00631Medicare UPIN
119611Medicare PIN