Provider Demographics
NPI:1750468468
Name:ZALE P. BERNSTEIN
Entity Type:Organization
Organization Name:ZALE P. BERNSTEIN
Other - Org Name:JONAH CENTER FOR CANCER CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZALE
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:716-898-5698
Mailing Address - Street 1:462 GRIDER STREET
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-5698
Mailing Address - Fax:716-898-4661
Practice Address - Street 1:462 GRIDER STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-5698
Practice Address - Fax:716-898-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147613174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0690Medicare ID - Type Unspecified