Provider Demographics
NPI:1689601817
Name:BERNSTEIN, SCOTT A (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 FIREMANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3553
Mailing Address - Country:US
Mailing Address - Phone:845-354-0011
Mailing Address - Fax:845-354-0147
Practice Address - Street 1:26 FIREMANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3553
Practice Address - Country:US
Practice Address - Phone:845-354-0011
Practice Address - Fax:845-354-0147
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01074322Medicaid
NYA61672Medicare UPIN
NY26E141Medicare ID - Type Unspecified