Provider Demographics
NPI:1700821766
Name:BERNSTEIN, JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
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 1:2035 LAKEVILLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1600
Mailing Address - Country:US
Mailing Address - Phone:516-328-9797
Mailing Address - Fax:516-352-6579
Practice Address - Street 1:2035 LAKEVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1600
Practice Address - Country:US
Practice Address - Phone:516-328-9797
Practice Address - Fax:516-352-6579
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205001207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH49220Medicare UPIN
018AD1Medicare ID - Type Unspecified