Provider Demographics
NPI:1659485506
Name:BERNSTEIN, PATRICIA B (PA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 BEL LIDO DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4204
Mailing Address - Country:US
Mailing Address - Phone:561-504-6411
Mailing Address - Fax:
Practice Address - Street 1:403 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4540
Practice Address - Country:US
Practice Address - Phone:561-266-8866
Practice Address - Fax:561-266-0033
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102433363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant