Provider Demographics
NPI:1598197071
Name:BERNSTEIN, RISA LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RISA
Middle Name:LYNN
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 HANNAFORD SQ STE 2
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-1653
Mailing Address - Country:US
Mailing Address - Phone:802-442-3642
Mailing Address - Fax:
Practice Address - Street 1:141 HANNAFORD SQ STE 2
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-1653
Practice Address - Country:US
Practice Address - Phone:802-442-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063838183500000X
NH3900183500000X
VT033.0097457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist