Provider Demographics
NPI:1558448803
Name:BERNSTEIN, MICHAEL F (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 SUNRISE HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-5909
Mailing Address - Country:US
Mailing Address - Phone:631-661-0022
Mailing Address - Fax:631-321-9615
Practice Address - Street 1:393 SUNRISE HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-5909
Practice Address - Country:US
Practice Address - Phone:631-661-0022
Practice Address - Fax:631-321-9615
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX001985-1111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT51944Medicare UPIN
NYX12051Medicare ID - Type Unspecified