Provider Demographics
NPI:1578564290
Name:BERNSTEIN, ALYSSA SUSAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:SUSAN
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2540
Mailing Address - Country:US
Mailing Address - Phone:732-388-3100
Mailing Address - Fax:732-388-4030
Practice Address - Street 1:560 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2540
Practice Address - Country:US
Practice Address - Phone:732-388-3100
Practice Address - Fax:732-388-4030
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ216681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice